Pharmacy Data Management User Manual · 01/18 127 PSS1212 Updated Pharmacy System Parameters Edit option 05/17 4 80-81 82-85 129-134 136-137 197 PSS1201 Updated Pharmacy Data

Pharmacy Data Management

User Manual

Version 1.0

Revised January 2020

Department of Veterans Affairs (VA)

Office of Information and Technology (OI&T)

January 2020 Pharmacy Data Management V. 1.0 i

User Manual

Revision History

Date Revised Pages Patch

Number Description

01/20 Title, i-vii, 96 PSS*1*240 • Updated URL in Example 1

• Updated Title page, Revision History, and Footers

(Joshua Smith – TW)

01/19 104, 105, 106,

109, 111, 114 -115 PSS*1*225 Added explanation and examples of the new

RESPIRATORY THERAPY DRUG? prompt under the Edit

Orderable Items [PSS EDIT ORDERABLE ITEMS] option.

(G. Miller, PM; T. Turowski, Tech Writer)

01/19 33, 78 PSS*1*214 Edit the NCPDP Quantity Multiplier to reflect 5 decimal

places

Display message if all EPHARMACY BILLABLE fields are

blank

(C. Fawcett, Analyst)

10/18 i-vii, Title Page, 34 PSS*1*218 • Updated title page to reflect month of release • Description of added DEA, SPECIAL HDLG field

value “K”. Updated figure for PSS DRUG ENTER/EDIT

help screen for the DEA,SPECIAL HDLG field

(G. Napoliello – Dev, E. Cook – TW)

08/18

68-71

77-78

PSS*1*227 Added sections to describe DRUG file (#50) audit

notifications and price change history.

Described changes to the [PSS LOOK] option resulting

from DRUG file price changes.

(R. Beltran-West, PM; E. Weaver, Tech Writer)

08/18 30-31 PSS*1*219 Added Information related to the new option ‘Manage Buprenorphine Tx of Pain Dosage Forms’ [PSS

BUPRENORPHINE DOSAGE FORMS].

03/18 20, 21 PSS*1*211 Modified the example for the noun/dosage report in section1.2.5.

(N. Boston Analyst CTT & DM NDS Medications Dosage Form)

03/18 Title Page, Revision History,

TOC, 45, 99, 100,

103, 105, and 107-110, 7-10, 34, 35,

37, 40, 41,46, 59, 63, 65, 67-70, 72,

76, 77, 85, 88, 90-92, 96, 102, 107,

108, 110, 114,

115, 118-122, 124, 126, 127, 136,

138-140, 143-145, 150-152, 154-157,

159, 161, 164-166,

169, and 171

PSS*1*204 Updated the Title Page, Revision History, and Table of

Contents.

Modified PDM adding two new fields: MOST COMMON INDICATION FOR USE (#14) and INDICATIONS FOR

USE (#13) to the PHARMACY ORDERABLE ITEM (#50.7)

file. These fields are displayed as part of the Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] option.

Made formatting changes throughout the document.

(Craig Hinton, PM; Blair Sanders, TW)

ii Pharmacy Data Management V. 1.0 January 2020

User Manual


Number Description

02/18 Title page

153-154

PSS*1*178 Updated title page to reflect month of release

Updated display for Check PEPS Service Setup option (S. Soldan PM, L. Bertuzis, BA; B. Hyde, TW)

01/18 127 PSS*1*212 Updated Pharmacy System Parameters Edit option

05/17 4

80-81

82-85

129-134

136-137

197

PSS*1*201

Updated Pharmacy Data Management options

Updated Section 1.7.1 Medication Instruction File Add/Edit Updated Section 1.7.2 Medication Instruction File Report

Updated Section 1.13.1 Standard Schedule Edit

Updated Section 1.13.2 Administration Schedule File Report

Added/Modified Glossary Terms

11/16 37-38, 41, 43-44,

49, 52, 55-56, 58,

66-67

73-75, 77

PSS*1*200 Updated Section 1.3 – Drug Enter/Edit Updated Section 1.6 – PSSLOOK

Updated Section 1.6 – PSNLOOK Updated Section 1.6 – PSNACT

(S. Pelchar PM; P. Crossman, Developer)

10/16 65, 66 PSS*1*193 Updated Section 1.3 – Drug Enter/Edit. (S. Soldan PM; R.Walters, Tech Writer)

08/16 32-34, 38-40, 49,

51, 53, 70-72, 100 PSS*1*192 Updated Title Page to current OI&T standards

Add fields to drug file for electronic billable determination

Add field to drug file for sensitive diagnosis drug

(S. Taubenfeld, PM; T. Rollins, Tech Writer)

06/16 i-ix

11

40-41

43

49

72-73

121-122

123

144

146-147

PSS*1*189 Updated Revision History and Table of Contents.

Added MAXIMUM DAYS SUPPLY to example Revised Section 1.3 - Drug Enter Edit Option

Added paragraph on Max days supply

Added Example 2: Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option (showing a maximum days supply of

365) Added MAXIMUM DAYS SUPPLY field in example

Added MAXIMUM DAYS Supply field in example Added MAXIMUM DAYS SUPPLY field in example for

[PSS LOOK] option

Added example 4 for PSNLOOK option. This option will display the MAXIMUM DAYS SUPPLY field

Added example 5 for PSNACT option. This option will display the MAXIMUM DAYS SUPPLY field

Updated Section 1.9.2 Dispense Drug/Orderable Item

Maintenance Added documentation to Section 1.13, Standard Schedule

Edit; Schedule Edit – Inactivate. Added Example: Inactive Administration Schedule

Added documentation to Section 1.13.2 - Administration Schedule File Report. Added Example: Administration

Schedule File Report

Added inactivation date for IV Additive Added inactivation date for IV Solutions

Added new rule regarding IV solutions matched to an Orderable. Added Example: Exclusion of duplicate

volumes within an Orderable Item

(A, Zak, T, Nixon, L. Ramos, Tech Writer)

January 2020 Pharmacy Data Management V. 1.0 iii

User Manual


Number Description

03/16 i-viii,

44, 87, 88, 89, 96

62-63

89-96

97-98

105-108

PSS*1*191 Updated TOC

Added HIGH RISK/HIGH ALERT and PROMPT FOR REMOVAL IN BCMA to several example screens.

Added Prompt for Removal in BCMA prompt information

to Section 1.3 Drug Enter/Edit [PSS DRUG ENTER/EDIT]. Added PROMPT FOR REMOVAL IN BCMA information,

HIGH RISK/HIGH ALERT prompt (from PSS*1*172) and added example 1 (PSS*1*191 Post-Install Report) to

section 1.9.1 Edit Orderable Items.

Added PROMPT FOR REMOVAL IN BCMA information, HIGH RISK/HIGH ALERT prompt (from PSS*1*172) to

1.9.2. Dispense Drug/Orderable Item Maintenance. Added PSS*1*191 enhancement information to section

1.9.6, Reports for Medications Requiring Removal (MRR): Orders for MRRs with Removal Properties, Orderable

Items that Require Removal Report, and Orderable Items

Report for High Risk/High Alert. (D. Connolly, PM; E. Phelps, R. Walters, Tech Writers)

03/14 All

i-vi, vii-viii,

1, 3, 5-10, 12-18,

20, 22, 24-30, 32-37, 39, 40, 41,

44, 46, 48, 49, 52, 54-58, 62, 63,

66-70, 72, 73, 75,

77, 78, 83-90, 93, 94, 97-100,

102-110, 112-115, 119-126, 128-130,

132-135, 138-140, 145-150, 154, 158,

170, 171,

221-222

PSS*1*161 Renumbered all pages Update TOC

Corrected menu option display text format throughout

document Added the numbers for all file and field entries throughout

document Added Lookup Dosing Check Info for Drug [PSS DRUG

DOSING LOOKUP] Option and Drug Names with Trailing

Spaces Report [PSS TRAILING SPACES REPORT] Option to the PDM menu [PSS MGR] structure

Added Enable/Disable Dosing Order Checks [PSS DOSING ORDER CHECKS] Option to the stand-alone

menu options Added section 1.2.9 Lookup Dosing Check Info for Drug

[PSS DRUG DOSING LOOKUP] Option

Removed section on daily dose range check Removed daily dose range check information from section

1.13.1 Added PSS*1*160 enhancement information to section

1.13.1

Added PSS*1*173 reference regarding MOCHA server display to section 1.20.1

Added PSS*1*160 enhancement information to section 1.13.2. Added Exclude from All Dose Checks and Exclude

from Daily Dose Check Added Domain Name Service for MOCHA server

information to section 1.20.1

Added 1.24.4 Enable/Disable Dosing Order Checks [PSS DOSING ORDER CHECKS] Option section

All Stand-Alone Menu Items section is now 1.24.5 Added Enable/Disable Dosing Order Checks [PSS

DOSING ORDER CHECKS] option to section 1.24.4 Added Note: The Dosage Checks are exported as turned

ON in patch PSS*1*160

iv Pharmacy Data Management V. 1.0 January 2020

User Manual


Number Description

Removed incorrectly attributed Patch from 1/13 Revision

History entry Corrected formatting, typographical, and spelling errors

Corrected File number for CREATE POSSIBLE DOSAGE

field Removed un-needed screen captures

Corrected File references Removed references to Test Accounts

Updated Glossary

Updated Index

(C. Powell, PM; S. Heiress, Tech Writer)

12/13 i-vi, 4, 44j-44l

102g-102h,

103-104,

105,

152-153,

204-206

PSS*1*172 New High Risk/High Alert functionality added to Pharmacy

Orderable Item File

New Infusion Instruction Management functionality added

to Pharmacy Data Management Option

Renumbered pages

Updated Glossary

Updated Index

(R. Santos, PM; B. Thomas, Tech Writer)

11/13 i-iv, v-vi,

26a-26b,

102a-102f

PSS*1*174 Update TOC

Identical additives and solutions

Additive and Generic Drug Distinction

Additive and Generic Drug Distinction, Solution Strength,

and Quick Codes

Additive Strength

01/13 i - vi, 4 - 4a, 26 –

26b, 100 - 100b,

101a – 101b, 102a – 102f, 103, 104-

104d, 105, 205 -

208

PSS*1*164

&

PSS*1*169

Added REQuest Change to Dose Unit example to the

Request Change Dose Unit section.

Added note to Check PEPS Services Setup section.

Added check options to the Vendor Database Reachable;

Enhanced Order Checks Executed example.

Added Print Interface Data File option

Added Section 1.21 Inpatient Drug Management as this

information was missing from patch PSS*1*146 release.

Added Section 1.22 Check Drug Interaction option

Added Find Unmapped Local Possible Dosages option

Updated the heading number for the Stand-Alone Menu

Options section this was previously 1.21 and is now 1.23.

Updated Index

(G. Tucker, PM; G. Scorca, Tech Writer)

06/12 i, ii, iii, 3-4, 4a –

4b, 44c, 44ib, 44j,

105

PSS*1*146 New sub-menu named Inpatient Drug Management [PSS

INP MGR]. Enter/Edit dosages Additive Solution

enhancement.

(N. Goyal, PM; J. Owczarzak Tech Writer)

01/12 i, ii, iii, 27, 44ia –

44ib, 89 PSS*1*156 New multiple named Outpatient Pharmacy Automation

Interface (OPAI) in the DRUG file (#50) sub-file

(#50.0906).

(N. Goyal, PM; J. Owczarzak Tech Writer)

January 2020 Pharmacy Data Management V. 1.0 v

User Manual


Number Description

12/11 i, ii, iii, 38-40b,

62d-64d

PSS*1*159 Updated screens. Updated the Edit Orderable Items option

for the default medication route. Due to data being moved,

pages 62e and 62f have been removed.

(N. Goyal, PM; C. Bernier Tech Writer)

08/11 i-iii, 101- 101b,

102 PSS*1*163 Updated the Schedule/Reschedule Check PEPS Interface

section

• Updated overview of Schedule/Reschedule Check

PEPS Interface

• Updated the Schedule/Reschedule Check PEPS

Interface example

• Added a warning regarding the DEVICE FOR

QUEUED JOB OUTPUT field

• Added a blank page for two-sided copying

(G. Tucker, PM; G. Scorca, Technical Writer)

04/11 i-iii, 3-4b, 7-16b,

44d-j, 114, 118,

121, 129, 137,

204-206

PSS*1*155 Utilized three new fields that were added to the VA

PRODUCT file (#50.68) with PSN*4*261. The fields are

used during the Match/Rematch process of the Drug Enter/Edit [PSS DRUG ENTER/EDIT] and the Enter/Edit

Dosages [PSS EDIT DOSAGES] options to determine whether possible dosages should be auto-created for

supra-therapeutic drugs.

Retired the Auto Create Dosages [PSS DOSAGE

CONVERSION] option and removed the option from the Dosages [PSS DOSAGES MANAGEMENT] menu.

Updated Index.

(N. Goyal, PM; E. Phelps/C. Bernier Tech Writers)

04/11 i, ii, iii, added iv, v;

changed 3, 4, 45, 46; added 46a-

46d, re-numbered all sections

starting on page

87 and ending with page 106;

changed page. 89; added 90e and

90f; changed 99-106; added 106a-

b; deleted 107-

112; changed 151,

153, 154; added

154a-b; updated

index;

PSS*1*136

&

PSS*1*117

Besides the developer’s changes, this document

incorporates the comments from Lina Bertuzis and colleagues for the PRE functionality included with patch

PSS*1*117 (a combined patch with PSS*1*136).

Sections changed are:

• Changed overview of menu item descriptions to

match application

• Changed menu item description named Drug

Interaction Management to Order Check

Management and changed text

• Changed submenu item Enter/Edit Local Drug

Interaction [PSS-INTERACTION-LOCAL-ADD] to Request Changes to Enhanced Order Check

Database. [PSS ORDER CHECK CHANGES] and

changed text.

• Changed example in Report of Locally Entered

Interactions option

Section deleted:

• Deleted Enhanced Order Checks Setup Menu and

all its sub-menu items (Find Unmapped Local Medication Routes; Map Local Medication Route to

Standard; Medication Route Mapping Report; Medication Route File Enter/Edit; Medication Route

Mapping History Report; Request Change to

vi Pharmacy Data Management V. 1.0 January 2020

User Manual


Number Description

Standard Medication Route; Find Unmapped Local

Possible Dosages; Map Local Possible Dosages; Local Possible Dosages Report; Strength Mismatch

Report; Enter/Edit Dosages; Request Change to

Dose Unit; Mark PreMix Solutions; IV Solution Report; Administration Schedule File Report;

Medication Instruction File Report)

The deleted Enhanced Order Checks Setup Menu and its

submenus is replaced by the following addition:

• Added PEPS Services menu and its submenus:

Check Vendor Database Link; Check PEPS Services

Setup; and Schedule/Reschedule PEPS Interface

Added a heading for Stand-Alone Menu Options with the description for the Enable/Disable Vendor Database Link

option and a short description for the Other Language

Translation Setup option.

Added definitions in the glossary for PECS and PEPS, and

updated the index.

(Jim Pollard, Project Manager, Ron Ruzbacki, Bill Tatum,

Developers; Marella Colyvas, Technical Writer)

04/11 i-ii, 38, 40, 62d-f,

64, 64a

PSS*1*153 Renamed the MED ROUTE field (#.06) of the PHARMACY

ORDERABLE ITEM file (#50.7) to be DEFAULT MED

ROUTE. Provided the ability to print the POSSIBLE MED ROUTES multiple on the Default Med Route For OI Report

[PSS DEF MED ROUTE OI RPT] option.

(N. Goyal, PM; E. Phelps, Tech Writer)

02/11 i, 63 PSS*1*142 Added functionality to denote the default med route for IV orders in the selection list in CPRS if all of the orderable

items on the order have the same default med route defined. Updated TOC. Released with CPRS version 28.

(N. Goyal, PM; E. Phelps/C. Bernier Tech Writers)

06/10 i, iii, 84, 84a-84b,

203, 205-206 PSS*1*143 Added new Schedule Validation Requirements. Updated

Index.

(R. Singer, DM; B. Thomas, Tech. Writer)

02/10 iii-iv, 3-4, 44a-d, 47-48, 61-62d, 89-

90b, 112, 203-206

PSS*1*147 Described new process for requesting changes to

Standard Medication Routes and the New Term Rapid

Turnaround (NTRT) process;

Added IV Additive/Solution Reports menu, with

suboptions

IV Solution Report option and V Additive Report [PSS IV

ADDITIVE REPORT] option

Added Default Med Route for OI Report option to the

Medication Routes Management... menu.(this change was

made but not documented with PSS*1*140)

Updated Drug Enter/Edit option to display NUMERIC DOSE and DOSE UNIT fields defined for Local Possible

Dosage

Updated the Drug Enter/Edit option display to include the

new ADDITIVE FREQUENCY field

Updated Table of Contents and Index

January 2020 Pharmacy Data Management V. 1.0 vii

User Manual


Number Description

(J.Freese, DM; K. Lowry, Tech. Writer)

10/09 i, 64a-b, 65, 65a-b,

66

PSS*1*141 Added ASSOCIATED IMMUNIZATION field to Edit

Orderable Items option and Dispense Drug/Orderable Item

Maintenance option. Reorganized content within sections

to accommodate new information.

(R. Singer, DM; D. Dertien/R. Silverman, Tech Writer)

08/09 iii-iv, 53,

62a-b, 63, 81, 203

PSS*1*140 Added DEFAULT MED ROUTE FOR CPRS field and

Default Med Route For OI Report [PSS DEF MED ROUTE

OI RPT] option for the enhancement of default medication

route being defined for an orderable item.

(G. Tucker, PM; S. B. Scudder, Tech. Writer)

07/09 27-34 PSS*1*131 Added explanations of DEA special handling code U for

sensitive drug.

(M. Anthony, PM; C. Liles, Tech. Writer)

05/09 81 PSS*1*137 Added Automate CPRS Refill field to the Pharmacy

System Parameters Edit [PSS MGR] option.

(G. Tucker, PM; S. B. Scudder, Tech. Writer)

02/09 All PSS*1*129 Pages renumbered to accommodate added pages.

Pharmacy Reengineering (PRE) V.0.5 Pre-Release.

Restructured Pharmacy Data Management menu:

- Grouped related options under the following new sub-

menus: Drug Text Management, Medication Instruction

Management, Medication Routes Management, and

Standard Schedule Management

- Added temporary Enhanced Order Checks Setup Menu

- Added the following options: Find Unmapped Local

Medication Routes, Find Unmapped Local Possible

Dosages, Map Local Medication Route to Standard, Map Local Possible Dosages, Mark PreMix Solutions, Request

Change to Dose Unit, and Request Change to Standard

Medication Route

- Added the following reports: Administration Schedule File

Report, IV Solution Report, Local Possible Dosages

Report, Medication Instruction File Report, Medication Route Mapping Report, Medication Route Mapping History

Report, and Strength Mismatch Report

- Updated Table of Contents, Index, and Glossary

(G. Tucker, PM; V. Howell, Tech. Writer)

09/97 Original Release of User Manual

viii Pharmacy Data Management V. 1.0 January 2020

User Manual

Table of Contents

Introduction .............................................................................................................................................. 1

Chapter One Pharmacy Data Management Options ........................................................................... 3

1.1 CMOP Mark/Unmark (Single drug) ......................................................................................... 6

1.2 Dosages ...................................................................................................................................... 7

1.2.1 Auto Create Dosages ................................................................................................................................. 8 1.2.2 Dosage Form File Enter/Edit ...................................................................................................................... 8 1.2.3 Enter/Edit Dosages .................................................................................................................................... 9 1.2.4 Most Common Dosages Report ................................................................................................................ 18 1.2.5 Noun/Dosage Form Report ...................................................................................................................... 20 1.2.6 Review Dosages Report ........................................................................................................................... 21 1.2.7 Local Possible Dosages Report ................................................................................................................. 23 1.2.8 Request Change to Dose Unit ................................................................................................................... 24 1.2.9 Lookup Dosing Check Info for Drug......................................................................................................... 26 1.2.10 Drug Names with Trailing Spaces Report .................................................................................................. 29 1.2.11 Manage Buprenorphine Tx of Pain Dosage Forms ..................................................................................... 30 [PSS BUPRENORPHINE DOSAGE FORMS] ....................................................................................................... 30

1.3 Drug Enter/Edit ....................................................................................................................... 31

1.3.1 Drug File Audits ..................................................................................................................................... 68 1.3.1.1 Drug File Audit Notification .............................................................................................................. 68 1.3.1.2 Drug Price Audit History................................................................................................................... 70

1.4 Order Check Management ...................................................................................................... 71 1.4.1 Request Changes to Enhanced Order Check Database ................................................................................ 72 1.4.2 Report of Locally Entered Interactions ...................................................................................................... 75

1.5 Electrolyte File (IV)................................................................................................................. 76

1.6 Lookup into Dispense Drug File ............................................................................................. 77

1.7 Medication Instruction Management ...................................................................................... 80

1.7.1 Medication Instruction File Add/Edit ........................................................................................................ 80 1.7.2 Medication Instruction File Report ........................................................................................................... 86

1.8 Medication Routes Management ............................................................................................. 90

1.8.1 Medication Route File Enter/Edit ............................................................................................................. 90 1.8.2 Medication Route Mapping Report ........................................................................................................... 92 1.8.3 Medication Route Mapping History Report ............................................................................................... 94 1.8.4 Request Change to Standard Medication Route.......................................................................................... 96 1.8.5 Default Med Route for OI Report ............................................................................................................ 100

1.9 Orderable Item Management ................................................................................................ 101

1.9.1 Edit Orderable Items............................................................................................................................... 102 1.9.2 Dispense Drug/Orderable Item Maintenance ............................................................................................ 115 1.9.3 Orderable Item/Dosages Report ............................................................................................................... 119 1.9.4 Patient Instructions Report ...................................................................................................................... 122 1.9.5 Orderable Item Report ............................................................................................................................ 123 1.9.6 Reports for Medications Requiring Removal (MRR) ................................................................................. 126

1.10 Formulary Information Report ............................................................................................. 129

1.11 Drug Text Management ........................................................................................................ 130

1.11.1 Drug Text Enter/Edit .............................................................................................................................. 130 1.11.2 Drug Text File Report ............................................................................................................................. 132

1.12 Pharmacy System Parameters Edit ....................................................................................... 134

1.13 Standard Schedule Management .......................................................................................... 135

1.13.1 Standard Schedule Edit ........................................................................................................................... 135 1.13.2 Administration Schedule File Report ....................................................................................................... 144

1.14 Synonym Enter/Edit .............................................................................................................. 146

January 2020 Pharmacy Data Management V. 1.0 ix

User Manual

1.15 Controlled Substances/PKI Reports ...................................................................................... 146

1.16 Send Entire Drug File to External Interface ........................................................................ 147

1.17 IV Additive/Solution .............................................................................................................. 148

1.17.1 IV Additive Report ................................................................................................................................. 148 1.17.2 IV Solution Report ................................................................................................................................. 150 1.17.3 Mark PreMix Solutions ........................................................................................................................... 152

1.18 Warning Builder .................................................................................................................... 153

1.19 Warning Mapping ................................................................................................................. 157

1.20 Pharmacy Enterprise Product System (PEPS) Services Menu ............................................. 159

1.20.1 Check Vendor Database Link .................................................................................................................. 159 1.20.2 Check PEPS Services Setup .................................................................................................................... 160 1.20.3 Schedule/Reschedule Check PEPS Interface ............................................................................................. 161 1.20.4 Print Interface Data File .......................................................................................................................... 163

1.21 Inpatient Drug Management ................................................................................................. 164

1.21.1 ADditives File........................................................................................................................................ 164 1.21.2 Dispense Drug Fields.............................................................................................................................. 166 1.21.3 Dispense Drug/ATC Set Up .................................................................................................................... 166 1.21.4 Edit Cost Data ........................................................................................................................................ 167 1.21.5 EDit Drug Cost (IV) ............................................................................................................................... 167 1.21.6 MARk/Unmark Dispense Drugs For Unit Dose ........................................................................................ 167 1.21.7 PRimary Solution File (IV) ..................................................................................................................... 167

1.22 Check Drug Interaction......................................................................................................... 168

1.23 Infusion Instruction Management ........................................................................................ 170

1.23.1 Infusion Instructions Add/Edit................................................................................................................. 171 1.23.2 Infusion Instructions Report .................................................................................................................... 171

1.24 Stand-Alone Menu Options ................................................................................................... 171

1.24.1 Enable/Disable Vendor Database Link ..................................................................................................... 172 1.24.2 Other Language Translation Setup ........................................................................................................... 172 1.24.3 Find Unmapped Local Possible Dosages .................................................................................................. 173 1.24.4 Enable/Disable Dosing Order Checks ...................................................................................................... 177 1.24.5 All Stand-Alone Menu Items ................................................................................................................... 178

Chapter Two Understanding Dosages ............................................................................................... 180

2.1 Possible Dosages ................................................................................................................... 180

2.2 Local Possible Dosages ......................................................................................................... 191

2.3 Possible Dosages and Local Possible Dosages ...................................................................... 195

2.4 Multi-Ingredient Drugs ......................................................................................................... 198

Chapter Three Creating the Sig ........................................................................................................ 200

3.1 Creating the Sig ..................................................................................................................... 200

3.2 SIG Formulas (Visual) .......................................................................................................... 201

3.3 SIG Formulas ........................................................................................................................ 202

Glossary ................................................................................................................................................ 208

Appendix A Convertible Dosage Form/Unit Combinations ............................................................ 213

Appendix B Original Drug Text File Entries Combinations ........................................................... 221

Appendix C Administration Schedules - Spanish Translations ....................................................... 223

Appendix D Dosage Forms - Spanish Translations .......................................................................... 229

Appendix E Local Possible Dosages - Spanish Translations ............................................................ 237

Appendix F Medication Instructions - Spanish Translations .......................................................... 243

x Pharmacy Data Management V. 1.0 January 2020

User Manual

Appendix G Medication Routes – Spanish Translations.................................................................. 257

Index...................................................................................................................................................... 261

January 2020 Pharmacy Data Management V. 1.0 1

User Manual

Introduction

Pharmacy Data Management (PDM) provides tools for managing Pharmacy data. It includes

tools for creating Pharmacy Orderable Items and maintaining files necessary for the

Computerized Patient Record System (CPRS). PDM consolidates tools for managing the various

Pharmacy software products. It provides Pharmacy Supervisors, in one location, the capability to

enter and edit data from the local DRUG file (#50) for all Pharmacy related packages. PDM now

allows users to enter medication instruction components (e.g., dosage, noun, verb, expansion) in

a language other than English. However, at this time, the Patient Medication Information Sheets

only allow patient data to be in English or Spanish.

The PDM user manual is designed to acquaint the user with the various PDM options and offer

specific guidance on the maintenance and use of the PDM package. Documentation concerning

the PDM package, including any subsequent change pages affecting this documentation, can be

found at the VistA documentation library.

Notations that will be used consistently throughout this PDM user manual are outlined below.

• Menu options will be italicized.

Example: The Drug Enter/Edit option permits you to enter or edit a drug.

• Screen prompts will be denoted with quotation marks around them.

Example: the “select drug” prompt will display next.

• Responses in bold face indicate user input.

Example: DRUG INTERACTION SEVERITY: CRITICAL

• Text centered between bent parentheses represents a keyboard key that needs to be pressed in

order for the system to capture a user response or move the cursor to another field.

<Enter> indicates that the Enter key (or Return key on some keyboards) must be pressed.

Example: Type Y for Yes or N for No and press <Enter>

<Tab> indicates that the Tab key must be pressed.

Example: Press <Tab> to move the cursor to the next field.

• Indicates especially important or helpful information.

• Options are locked with a particular security key. The user must hold the particular

security key to be able to perform the menu option.

Example: Without the PSXCMOPMGR key, the Consolidated Mail Outpatient

Pharmacy options cannot be accessed.

2 Pharmacy Data Management V. 1.0 January 2020

User Manual

• The page symbol indicates a referral to a diagram.

• ?, ??, ??? One, two or three question marks can be entered at any of the prompts for online

help. One question mark elicits a brief statement of what information is appropriate for the

prompt. Two question marks provide more help, plus the hidden actions, and three question

marks will provide more detailed help, including a list of possible answers, if appropriate.

• ^ Up arrow (caret or a circumflex) and pressing <Enter> can be used to exit the present

option.


User Manual

Chapter One Pharmacy Data Management Options

The PDM options listed below show the Menu structure following the installation of PSS*1*160.

Each of these options is discussed in detail later in this user manual.

CMOP Mark/Unmark (Single drug)

Dosages ...

Dosage Form File Enter/Edit

Enter/Edit Dosages

Most Common Dosages Report

Noun/Dosage Form Report

Review Dosages Report

Local Possible Dosages Report

Request Change to Dose Unit

Lookup Dosing Check Info for Drug

Drug Names with Trailing Spaces Report

Drug Enter/Edit

Order Check Management…

Request Changes to Enhanced Order Check Database

Report of Locally Entered Interactions

Electrolyte File (IV)

Lookup into Dispense Drug File

Medication Instruction Management ...

Medication Instruction File Add/Edit

Medication Instruction File Report

Medication Routes Management ...

Medication Route File Enter/Edit

Medication Route Mapping Report

Medication Route Mapping History Report

Request Change to Standard Medication Route

Default Med Route for OI Report

Orderable Item Management ...

Edit Orderable Items

Dispense Drug/Orderable Item Maintenance

Orderable Item/Dosages Report

Patient Instructions Report

Orderable Item Report

Formulary Information Report

Drug Text Management ...

Drug Text Enter/Edit

Drug Text File Report

Pharmacy System Parameters Edit

Standard Schedule Management ...

Standard Schedule Edit

Administration Schedule File Report

Synonym Enter/Edit

The CMOP Mark/Unmark

(Single drug) option is displayed

before the Warning Builder

option in the PDM Main Menu.

For documentation purposes, it is

being left at the beginning of this

menu.


User Manual

Controlled Substances/PKI Reports… DEA Spec Hdlg & CS Fed Sch Discrepancy Controlled Substances Not Matched to NDF CS (DRUGS) Inconsistent with DEA Spec Hdlg CS (Ord. Item) Inconsistent with DEA Spec Hdlg

Send Entire Drug File to External Interface

IV Additive/Solution…

IV Additive Report

IV Solution Report

Mark PreMix Solutions Warning Builder Warning Mapping PEPS Services… Check Vendor Database Link Check PEPS Services Setup Schedule/Reschedule Check PEPS Interface

Print Interface Data File

Inpatient Drug Management…

ADditives File

Dispense Drug Fields

Dispense Drug/ATC Set Up

Edit Cost Data

EDit Drug Cost (IV)

MARk/Unmark Dispense Drugs For Unit Dos

PRimary Solution File (IV)

Check Drug Interaction

Infusion Instruction Management …

Infusion Instructions Add/Edit

Infusion Instruction Report

Orders for MRRs With Removal Properties


User Manual

Stand-Alone Menu Options

The following is a list of all stand-alone options that are NOT exported as part of the main PDM

menu [PSS MGR]:

*Other Language Translation Setup

[PSS OTHER LANGUAGE SETUP]

Drug Inquiry (IV)

[PSSJI DRUG INQUIRY]


[PSSJI ELECTROLYTE FILE]

Enable/Disable Vendor Database Link

[PSS ENABLE/DISABLE DB LINK]

Find Unmapped Local Possible Dosages

[PSS LOCAL DOSAGES EDIT ALL]

Add Default Med Route

[PSS ADD DEFAULT MED ROUTE]

Enable/Disable Dosing Order Checks

[PSS DOSING ORDER CHECKS]

The Enable/Disable Vendor Database Link [PSS ENABLE/DISABLE DB

LINK] option exists ONLY as a way for technical personnel to turn on/off the database

connection if required for debugging. Normally, it is enabled and the Vendor Database

updates are performed centrally on the MOCHA servers, not at the individual sites. This

option is rarely used. It is NOT exported as part of the main PDM menu [PSS MGR]

In the rare case where this option is used and the database link is disabled, NO drug-drug

interaction, duplicate therapy, or dosing order checks will be performed in Pharmacy or

in the Computerized Patient Record System (CPRS).

*Other Language Translation Setup [PSS OTHER LANGUAGE SETUP] option is a stand-

alone option that must be assigned to the person(s) responsible for maintaining it.

The Enable/Disable Dosing Order Checks [PSS DOSING ORDER CHECKS] option

exists ONLY as a way for technical personnel to turn on/off Dosing Order Checks if

authorized by Pharmacy Benefits Management (PBM). This option is rarely used. It is

NOT exported as part of the main PDM menu [PSS MGR]


User Manual

1.1 CMOP Mark/Unmark (Single drug) [PSSXX MARK]

The CMOP Mark/Unmark (Single drug) [PSSXX MARK] option allows the user to

mark/unmark a single drug for transmission to the Consolidated Mail Outpatient Pharmacy

(CMOP). Pertinent DRUG file (#50) and VA PRODUCT file (#50.68) fields shall be displayed

to the user for review whenever a drug is marked or unmarked for CMOP transmission.

If the user marks the entry to transmit to CMOP, it will replace the Dispense Unit with the VA

Dispense Unit. In addition, if the user overwrites the local drug name with the VA Print Name,

the entry may not be edited. The VA Print Name will be displayed on all profiles and

prescription labels if the local drug name is overwritten with the VA Print Name. The local drug

name will no longer be selectable during order entry.

If the user chooses not to overwrite the local drug name with the VA Print Name, the local drug

name will continue to be displayed on all profiles and can be used for drug selection during order

entry. The VA Print Name will be displayed on all prescription labels regardless of the local drug

name.

A drug cannot be marked for CMOP if:

1. It is inactive in DRUG file (#50) or VA PRODUCT file (#50.68).

2. It is not marked for Outpatient Medications use.

3. It is not matched to National Drug File.

4. It is a Schedule I or II narcotic.

5. It is not marked for CMOP in National Drug File.

The ability to mark/unmark a single drug for CMOP transmission is also available utilizing the

Drug Enter/Edit [PSS DRUG ENTER/EDIT] option.

Locked: PSXCMOPMGR Without the PSXCMOPMGR key, the CMOP Mark/Unmark (Single drug) [PSSXX MARK] option will not appear on your menu.

When using the CMOP Mark/Unmark (Single drug) [PSSXX MARK] option to mark a drug for CMOP the user must update the cost information in the DRUG file (#50) to ensure the cost data for each prescription fill will be correct. Use the Drug Enter/Edit option [PSS DRUG ENTER/EDIT] to edit the price per order unit and the dispense units per order unit when appropriate.

Example 1: Marking a CMOP Drug (Single drug) [PSSXX MARK] Option

Select Pharmacy Data Management Option: CMOP Mark/Unmark (Single drug) This option allows you to choose entries from your drug file and helps you

review your NDF matches and mark individual entries to send to CMOP. If you mark the entry to transmit to CMOP, it will replace your Dispense Unit with the VA Dispense Unit. In addition, you may overwrite the local drug name


User Manual

with the VA Print Name and the entry will remain uneditable.

Select DRUG GENERIC NAME: GUAIFENESIN 100MG/5ML LIQUID RE302

Local Drug Generic Name: GUAIFENESIN 100MG/5ML LIQUID ORDER UNIT: 120ML

DISPENSE UNITS/ORDER UNITS: 120 DISPENSE UNIT: EA PRICE PER DISPENSE UNIT: 0.01 VA Print Name: GUAIFENESIN 100MG/5ML SYRUP VA Dispense Unit: ML VA Drug Class: RE302 CMOP ID: G0035

Do you wish to mark this drug to transmit to CMOP? Enter Yes or No: YES QUANTITY DISPENSE MESSAGE: ENTER IN MULTIPLES OF 120. Your old Dispense Unit EA does not match the new one ML.

You may wish to edit the Price Per Order Unit and/or The Dispense Units Per Order Unit.

Do you wish to overwrite your local name? Enter Yes or No: YES Select DRUG GENERIC NAME:

Example 2: Unmarking a CMOP Drug (Single drug) [PSSXX MARK] Option

Select DRUG GENERIC NAME: GUAIFENESIN 100MG/5ML SYRUP RE302 Local Drug Generic Name: GUAIFENESIN 100MG/5ML SYRUP ORDER UNIT: 120ML

DISPENSE UNITS/ORDER UNITS: 120 DISPENSE UNIT: ML PRICE PER DISPENSE UNIT: 0.01 VA Print Name: GUAIFENESIN 100MG/5ML SYRUP VA Dispense Unit: ML

VA Drug Class: RE302 CMOP ID: G0035

Do you wish to UNmark this drug to transmit to CMOP? Enter Yes or No: YES Select DRUG GENERIC NAME:

1.2 Dosages [PSS DOSAGES MANAGEMENT]

The Dosages [PSS DOSAGES MANAGEMENT] option controls the entering and editing of

dosages. The dosages sub-options are explained in more detail below.


User Manual

1.2.1 Auto Create Dosages [PSS DOSAGE CONVERSION]

The Auto Create Dosages [PSS DOSAGE CONVERSION] option was removed from the

Dosages [PSS DOSAGES MANAGEMENT] menu by PSS*1*155.

1.2.2 Dosage Form File Enter/Edit [PSS DOSAGE FORM EDIT]

The Dosage Form File Enter/Edit [PSS DOSAGE FORM EDIT] option provides the ability to

edit data in the DOSAGE FORM file (#50.606). Changes made using this option may affect the

way CPRS and Outpatient Pharmacy SIGs display and how Local Possible Dosages are created.

The Noun entries are used to populate the Local Possible Dosages for DRUG file (#50) entries,

when these entries are matched to National Drug File. These Nouns may be package specific (i.e.

Outpatient Pharmacy, Inpatient Medications, or both). Entries in this file will be used as default

values in the construction of the Outpatient Pharmacy prescription SIG.

The conjunction will be used to provide a connector between the Local Possible Dosage and the

strength and units or Dispense Drug name when displaying the dosage list through CPRS. For

example, the dosage 1 TEASPOONFUL GUAIFENESIN WITH DEXTROMETHORPHAN

SYRUP would display as 1 TEASPOONFUL OF GUAIFENESIN WITH

DEXTROMETHORPHAN SYRUP in CPRS after the conjunction “OF” was provided using the

Dosage Form File Enter/Edit [PSS DOSAGE FORM EDIT] option.

The Dosage Form File Enter/Edit [PSS DOSAGE FORM EDIT] option allows the user to

associate one or more local medication routes with a dosage form. The user will only be able to

select a local medication route that has already been defined in the MEDICATION ROUTES file

(#51.2).

The Dosage Form File Enter/Edit [PSS DOSAGE FORM EDIT] option allows the user to enter

a noun, verb, or preposition in a language other than English. PDM does not translate English

terms into another language; instead, it allows the user to enter a translation of a term. If a value

has not been entered in the OTHER LANGUAGE VERB, OTHER LANGUAGE

PREPOSITION, or OTHER LANGUAGE NOUN fields, PDM defaults to the values entered in

the VERB, PREPOSITION, or NOUN fields. If the VERB, PREPOSITION, or NOUN fields do

not contain data for the selected item, the system will not display default values for those fields

during CPRS or Outpatient Pharmacy prescription order entry processing. However, when

building the SIG, Outpatient Pharmacy will default to the values the user input during order

entry. See Appendix D for a list of Spanish equivalents for some of the more common dosage

forms.

Example: Dosage Form File Enter/Edit [PSS DOSAGE FORM EDIT] Option

Select Dosages Option: DOSage Form File Enter/Edit

Select DOSAGE FORM NAME: TAB

NAME: TAB <Enter>


User Manual

Select MED ROUTE FOR DOSAGE FORM: ORAL// <Enter>

VERB: TAKE// <Enter>

OTHER LANGUAGE VERB: TOMAR

PREPOSITION: BY// <Enter>

OTHER LANGUAGE PREPOSITION: POR

Select NOUN: TABLET(S)// <Enter>

NOUN: TABLET(S)// <Enter>

OTHER LANGUAGE NOUN: TABLETAS// TABLETA(S)

PACKAGE: Both// <Enter>

Select NOUN: <Enter>

CONJUNCTION: OF// <Enter>

1.2.3 Enter/Edit Dosages [PSS EDIT DOSAGES]

The Enter/Edit Dosages [PSS EDIT DOSAGES] option allows you to edit Possible Dosages and

Local Possible Dosages for a selected Dispense Drug. These dosages may be specified for

Inpatient Medications, Outpatient Pharmacy, or both packages.

The BCMA UNITS PER DOSE sub-field (#3) of the POSSIBLE DOSAGES multiple (#903) of

the DRUG file (#50) and the BCMA UNITS PER DOSE sub-field (#2) of the LOCAL

POSSIBLE DOSAGE multiple (#904) of the DRUG file (#50) are used by Inpatient Medications

to populate the Units Per Dose information for Unit Dose orders. This value will determine the

number of times a medication must be scanned in order to document a medication administration

through Bar Code Medication Administration (BCMA). This field is not required and an entry

should be made only when multiple scans through BCMA appear to document erroneous

dosages.

The Enter/Edit Dosages [PSS EDIT DOSAGES] option allows the user to enter a dosage in a

language other than English. PDM does not translate English terms into another language;

instead, it allows the user to enter a translation of a term. If a value has not been entered in the

OTHER LANGUAGE DOSAGE NAME sub-field (#3) of the LOCAL POSSIBLE DOSAGE

multiple (#904) of the DRUG file (#50), PDM defaults to the value entered in the LOCAL

POSSIBLE DOSAGE sub-field (#.01) of the LOCAL POSSIBLE DOSAGE multiple (#904) of

the DRUG file (#50). If no values exist in the LOCAL POSSIBLE DOSAGE sub-field (#.01) of

the LOCAL POSSIBLE DOSAGE multiple (#904) of the DRUG file (#50) and OTHER

LANGUAGE DOSAGE NAME sub-field (#3) of the LOCAL POSSIBLE DOSAGE multiple

(#904) of the DRUG file (#50), the system will not display default values for those fields during

CPRS or Outpatient Pharmacy prescription order entry processing. However, when building the

SIG, Outpatient Pharmacy will default to the value the user input during order entry. See

Appendix E for a list of Spanish equivalents for some of the more common Local Possible

Dosages.

The NUMERIC DOSE sub-field (#5) and DOSE UNIT sub-field (#4) of the LOCAL POSSIBLE

DOSAGES multiple (#904) in DRUG file (#50) are used to breakdown a free text Local Possible

Dosage in order to perform dosage checks when that Local Possible Dosage is selected for an

eligible drug within an order. When populating the DOSE UNIT sub-field (#4) of the LOCAL

POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) for a Local Possible Dosage,

selection will be from the DOSE UNITS file (#51.24). A Numeric Dose will have to be entered

that corresponds to the Dose Unit selected. No auto population is provided. If any of the


User Manual

following conditions can be determined at the time of entry, the NUMERIC DOSE sub-field (#5)

of the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) and DOSE UNIT

sub-field (#4) of the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) for

any defined Local Possible Dosage will not be displayed for data entry.

• Drug associated with a dosage form that is excluded from dosage checks and the VA

Product that the drug is matched to has the OVERRIDE DF DOSE CHK EXCLUSION

field (#31) of the VA PRODUCT file (#50.68) set to ‘No’

• Drug associated with a dosage form that is NOT excluded from dosage checks, but the

VA Product that it is matched to has the OVERRIDE DF DOSE CHK EXCLUSION

field (#31) of the VA PRODUCT file (#50.68) set to ‘Yes’

• Drug is marked as a supply item (‘S’ in DEA, SPECIAL HDLG field (#3) of the DRUG

file (#50) or assigned a VA Drug Class starting with an ‘XA’)

Although ineligible for dosage checks, when editing a Local Possible Dosage for an inactive

drug or a drug not matched to NDF, the NUMERIC DOSE sub-field (#5) of the LOCAL

POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) and DOSE UNIT sub-field (#4) of

the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) will be displayed to the

user for data entry.

A warning will be displayed if the DRUG file (#50) STRENGTH field (#901) does not match the

VA Product strength to which it is matched.

Example 1: Enter/Edit Dosages [PSS EDIT DOSAGES] Option

Select DRUG GENERIC NAME: ACETAMINOPHEN 120MG/5ML LIQUID CN103

...OK? Yes// (Yes)

*******************************************************************************

This entry is marked for the following PHARMACY packages:

Outpatient

Unit Dose

Non-VA Med

GENERIC NAME: ACETAMINOPHEN 120MG/5ML LIQUID Replace

VA CLASSIFICATION: CN103//

DEA, SPECIAL HDLG: 9//

DAW CODE:

NATIONAL FORMULARY INDICATOR: YES

LOCAL NON-FORMULARY:

VISN NON-FORMULARY:

Select DRUG TEXT ENTRY:

Select FORMULARY ALTERNATIVE:

Select SYNONYM: 000054301050//

SYNONYM: 000054301050//

INTENDED USE: DRUG ACCOUNTABILITY//

NDC CODE: 000054-3010-50//

Select SYNONYM:

MESSAGE:

RESTRICTION:

FSN:

NDC: 00904-1985-16//

INACTIVE DATE:


User Manual

WARNING LABEL SOURCE is 'NEW'.

The following WARNING LABEL may continue to be used for a limited time for some

external interfaces.

WARNING LABEL: 8//

Current Warning labels for ACETAMINOPHEN 120MG/5ML LIQUID

Labels will print in the order in which they appear for local and CMOP fills:

8N Do not drink alcoholic beverages when taking this medication.

66N This medicine contains ACETAMINOPHEN.Taking more ACETAMINOPHEN than

recommended may cause serious liver problems.

70N Do not take other ACETAMINOPHEN containing products at the same time

without first checking with your doctor. Check all medicine labels carefully.

Pharmacy fill card display: DRUG WARNING 8N,66N,70N

NOTE: Because the NEW WARNING LABEL LIST field is empty, the warnings above

are the warnings that our national data source distributes for this drug.

Would you like to edit this list of warnings? N// O

ORDER UNIT: BT//

PRICE PER ORDER UNIT: 2//

DISPENSE UNIT: ML//

DISPENSE UNITS PER ORDER UNIT: 480//

NCPDP DISPENSE UNIT: MILLILITERS//

NCPDP QUANTITY MULTIPLIER: 1//

MAXIMUM DAYS SUPPLY: 120//

PRICE PER DISPENSE UNIT: 0.0042

points to ACETAMINOPHEN 160MG/5ML ELIXIR in the National Drug file.

This drug has already been matched and classified with the National Drug

file. In addition, if the dosage form changes as a result of rematching,

you will have to match/rematch to Orderable Item.

Do you wish to match/rematch to NATIONAL DRUG file? No// (No)

Just a reminder...you are editing ACETAMINOPHEN 120MG/5ML LIQUID.

Strength from National Drug File match => 160 MG/5ML

Strength currently in the Drug File => 120

Please note: Strength of drug does not match strength of VA Product it is

matched to.

Press Return to Continue:

Strength => 120 Unit =>

POSSIBLE DOSAGES:

DISPENSE UNITS PER DOSE: 1 DOSE: 120MG/3.75ML PACKAGE: I

DISPENSE UNITS PER DOSE: 2 DOSE: 240MG/7.5ML PACKAGE: I

LOCAL POSSIBLE DOSAGES:

LOCAL POSSIBLE DOSAGE: 1 TEASPOONFUL PACKAGE: IO

LOCAL POSSIBLE DOSAGE: 2 TEASPOONSFUL PACKAGE: IO

LOCAL POSSIBLE DOSAGE: 1 TABLESPOONFUL PACKAGE: O

LOCAL POSSIBLE DOSAGE: 2 TABLESPOONSFUL PACKAGE: IO

Do you want to edit the dosages? N// YES

Changing the strength will update all possible dosages for this Drug.

STRENGTH: 120//

Select DISPENSE UNITS PER DOSE:


User Manual

Strength: 120 Unit: MG/5ML

Select LOCAL POSSIBLE DOSAGE: 1 TEASPOONFUL IO

LOCAL POSSIBLE DOSAGE: 1 TEASPOONFUL//

OTHER LANGUAGE DOSAGE NAME:

PACKAGE: Both//

BCMA UNITS PER DOSE:

NUMERIC DOSE: 120//


Select LOCAL POSSIBLE DOSAGE:

*******************************************************************************


Outpatient

Unit Dose

Non-VA Med

MARK THIS DRUG AND EDIT IT FOR:

O - Outpatient

U - Unit Dose

I - IV

W - Ward Stock

D - Drug Accountability

C - Controlled Substances

X - Non-VA Med

A - ALL

Enter your choice(s) separated by commas : ^

** You are NOW in the ORDERABLE ITEM matching for the dispense drug. **

ACETAMINOPHEN 120MG/5ML LIQUID is already matched to

ACETAMINOPHEN ELIXIR

Do you want to match to a different Orderable Item? NO//

Select DRUG GENERIC NAME:

Example 2: Enter/Edit Dosages [PSS EDIT DOSAGES] Option Create a Local Possible Dosage

Select Dosages Option: ENter/Edit Dosages

Select Drug: GUAIFENESIN 100MG/5ML SYRUP RE302 DISP BY ML(120

ML MAX/NON-REFILLABLE)mpr 1BT=120ML *OTC DRUG* $ 6/02


Outpatient

Unit Dose

Non-VA Med

GUAIFENESIN 100MG/5ML SYRUP Inactive Date:



Edit Strength? N// <Enter>O


Select DISPENSE UNITS PER DOSE: ?

Answer with POSSIBLE DOSAGES DISPENSE UNITS PER DOSE

Choose from:

1 100 I

2 200 I

<< Fields displayed when drug eligible for dosage check


User Manual

You may enter a new POSSIBLE DOSAGES, if you wish

Type a Number between 0 and 99999999, 4 Decimal Digits

Select DISPENSE UNITS PER DOSE: <Enter>

This drug has the following Local Possible Dosages:

2 TEASPOONFULS PACKAGE: O

10 MLS PACKAGE: I

Do you want to merge new Local Possible Dosages? Y// <Enter> YES

Setting Local Possible Dosages..


Select LOCAL POSSIBLE DOSAGE: 2 TEASPOONFULS O

LOCAL POSSIBLE DOSAGE: 2 TEASPOONFULS// <Enter>

OTHER LANGUAGE DOSAGE NAME: 2 CUCHARADITAS

PACKAGE: Outpatient// <Enter>

DOSE UNIT: MILLIGRAM(S)

NUMERIC DOSE: 200


Example 3: Enter/Edit Dosages [PSS EDIT DOSAGES] Option Editing the Dispense Units Per Dose


Select Drug: PROPR

1 PROPRANOLOL 10MG S.T. CV100



4 PROPRANOLOL TABS,80MG.PINACIDIL STUDY STUDY DRUG

CHOOSE 1-4: 2 PROPRANOLOL 40MG S.T. CV100


Outpatient

Unit Dose

Non-VA Med

PROPRANOLOL 40MG S.T. Inactive Date:

Strength from National Drug File match => 40 MG

Strength currently in the Drug File => 40 MG

Edit Strength? N// <Enter> O

Strength => 40 Unit => MG

Select DISPENSE UNITS PER DOSE: 0.5

Are you adding '.5' as a new POSSIBLE DOSAGES (the 3RD for this DRUG)? No// Y

(Yes)

Dosage = 20MG

POSSIBLE DOSAGES DOSE: 20// (No Editing) <Enter>

DISPENSE UNITS PER DOSE: 0.5// <Enter>

PACKAGE: IO <Enter>

BCMA UNITS PER DOSE: <Enter>



Enter/Edit Local Possible Dosages? N// <Enter> O

Select Drug:


User Manual

Example 4: Enter/Edit Dosages [PSS EDIT DOSAGES] Option Creating Possible Dosages


Select Drug: GRISEOFULVIN 500MG S.T. AM700


Outpatient

Unit Dose

Non-VA Med

GRISEOFULVIN 500MG S.T. Inactive Date:

This drug can have Possible Dosages, but currently does not have any.

Create Possible Dosages for this drug? N// ?

This drug meets the criteria to have Possible Dosages, but it currently does

not have any. If you answer 'YES', Possible Dosages will be created for this

drug, based on the match to the National Drug File.

Create Possible Dosages for this drug? N// YES

Resetting Possible Dosages..

Press Return to continue: <Enter>



Edit Strength? N// <Enter> O




Choose from:

1 500 IO

2 1000 IO




Enter/Edit Local Possible Dosages? N// <Enter> O

Select Drug:

Example 5: Enter/Edit Dosages [PSS EDIT DOSAGES] Option Strength Mismatch

Select Dosages Option: Enter/Edit Dosages

Select Drug: ACETAMINO

1 ACETAMINOPHEN 1000MG TABLET CN100

2 ACETAMINOPHEN 325MG C.T. CN103 ** OK 90 DAY SUPPLY **

3 ACETAMINOPHEN 325MG TABLET CN103 INFECTIOUS DISEASE

RESTRICTED TO

4 ACETAMINOPHEN 650MG SUPPOS. CN103

5 ACETAMINOPHEN ELIX. 120MG/5ML 4OZ CN103

Press <ENTER> to see more, '^' to exit this list, OR

CHOOSE 1-5: 5 ACETAMINOPHEN ELIX. 120MG/5ML 4OZ CN103


Outpatient

Unit Dose

Non-VA Med

ACETAMINOPHEN ELIX. 120MG/5ML 4OZ Inactive Date:


User Manual



Please Note: Strength of drug does not match strength of VA Product it is matched to.

Press Return to Continue: <ENTER>

Edit Strength? N// <ENTER> O


Select DISPENSE UNITS PER DOSE: <ENTER>


Select LOCAL POSSIBLE DOSAGE: ?

You may enter a new LOCAL POSSIBLE DOSAGE, if you wish

Answer must be 1-60 characters in length.

Select LOCAL POSSIBLE DOSAGE: ONE TEASPOONFUL

Are you adding 'ONE TEASPOONFUL' as

a new LOCAL POSSIBLE DOSAGE (the 1ST for this DRUG)? No// Y (Yes)

LOCAL POSSIBLE DOSAGE: ONE TEASPOONFUL// <ENTER>

OTHER LANGUAGE DOSAGE NAME: <ENTER>

PACKAGE: O Outpatient


NUMERIC DOSE: 120


Select LOCAL POSSIBLE DOSAGE: <ENTER>

Select Drug:

Example 6: Enter/Edit Dosages [PSS EDIT DOSAGES] Option Drug not eligible for dosage checks (NUMERIC DOSE sub-field (#5) of the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) and DOSE UNIT sub-field (#4) of the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) not displayed)

Select Dosages Option: ENTER/EDIT Dosages

Select Drug: HYDROCORTISONE

1 HYDROCORTISONE 0.5% CR DE200

2 HYDROCORTISONE 1% CREAM DE200

3 HYDROCORTISONE 1% CREAM (PKT) DE200

4 HYDROCORTISONE 1% LOTION DE200

5 HYDROCORTISONE 1% OINT DE200

Press <RETURN> to see more, '^' to exit this list, OR

CHOOSE 1-5: 2 HYDROCORTISONE 1% CREAM DE200


Outpatient

Unit Dose

Non-VA Med

HYDROCORTISONE 1% CREAM Inactive Date:


SMALL AMOUNT PACKAGE: IO

MODERATE AMOUNT PACKAGE: IO

LIBERAL AMOUNT PACKAGE: IO

Do you want to merge new Local Possible Dosages? Y// NO


User Manual

Strength: 1 Unit: %

Select LOCAL POSSIBLE DOSAGE: SMALL AMOUNT IO

LOCAL POSSIBLE DOSAGE: SMALL AMOUNT// <ENTER>

PACKAGE: Both// <ENTER>

BCMA UNITS PER DOSE: <ENTER>

Strength: 1 Unit: %


Patch PSS*1*155 addresses supra-therapeutic and sub-therapeutic dosages. A supra-therapeutic

dosage is one that far exceeds the normal therapeutic range. A sub-therapeutic dosage is one that

is far below the normal therapeutic range. Certain drugs with an automatically calculated dosage

of one time or two times the base strength that is supra- or sub-therapeutic will be adjusted to not

auto-create those default possible dosages. Such changes will be distributed during the Monthly

NDF Updates. PSS*1*155 uses the three new fields that were added to the VA PRODUCT file

(#50.68) by PSN*4*261 to prevent the inadvertent creation of supra-therapeutic possible dosages

for high risk medications during the dosage creation segment of Pharmacy Data Management

and National Drug File updates. These fields will be used during the Match/Rematch process of

the Enter/Edit Dosages [PSS EDIT DOSAGES] option to determine if possible dosages should

be auto-created or not. The three fields are:

• CREATE DEFAULT POSSIBLE DOSAGE field (#40)

• POSSIBLE DOSAGES TO CREATE field (#41)

• PACKAGE field (#42)

When CREATE DEFAULT POSSIBLE DOSAGE field (#40) is “YES”, then the existing

functionality of auto-creating possible dosages will apply. When this field is “NO”, it will be

used in combination with the value in POSSIBLE DOSAGES TO CREATE field (#41) to

determine the auto-creation of possible dosages.

The following conditions will apply when CREATE DEFAULT POSSIBLE DOSAGE

field (#40) is “NO”:

• If POSSIBLE DOSAGES TO CREATE field (#41) is “NO”, no possible dosages will be

auto-created and the following message will be displayed:

“Due to National Drug File settings no possible dosages were auto-created.”

• If POSSIBLE DOSAGES TO CREATE field (#41) is "O", 1x possible dosage will be

auto-created for the package specified by the new PACKAGE field (#42) and the

following message will be displayed:

“Due to National Drug File settings only one possible dosage will be auto-created.

• If other dosages are needed, create POSSIBLE DOSAGES or LOCAL POSSIBLE

DOSAGES as appropriate.”

• If POSSIBLE DOSAGES TO CREATE field (#41) is “B”, 1x and 2x possible dosages

will be auto-created for the package specified by the new PACKAGE field (#42) and the


• “Due to National Drug File settings TWO possible dosages were auto-created.”


User Manual

Example 1: Supra-Therapeutic Drugs – Enter/Edit Dosages [PSS EDIT DOSAGES] Option – Messages

displayed when Create Default Possible Dosage is No and Possible Dosages To Create is No in the National

Drug File

Select Dosages Option: Enter/Edit Dosages

Select Drug: NIACIN 100MG TAB VT103


Outpatient

Unit Dose

Non-VA Med

NIACIN 100MG TAB Inactive Date:


This drug has been set within the National Drug File to not auto create possible dosages.

Do you want to manually enter possible dosages? N// ?

This drug meets the criteria to have Possible Dosages, but it currently does

not have any. If you answer 'YES', Possible Dosages can be manually entered for this drug.

Do you want to manually enter possible dosages? N// YES



Edit Strength? N// O






Example 2: Supra-Therapeutic Drugs – Enter/Edit Dosages [PSS EDIT DOSAGES] Option – Messages displayed when resetting possible dosages, when Create Default Possible Dosage is No and Possible Dosages To Create is O in the National Drug File



Outpatient

Unit Dose

Non-VA Med



This drug has been set within the National Drug File to auto create only one possible dosage.



Due to National Drug File settings only ONE possible dosage was auto- created. If other dosages

are needed, create POSSIBLE DOSAGES or LOCAL POSSIBLE DOSAGES as appropriate

Press Return to continue:

<< Prompt displayed when no possible dosages were auto-created


User Manual







Choose from:

1 100 IO




Example 3: Supra-Therapeutic Drugs – Enter/Edit Dosages [PSS EDIT DOSAGES] Option – Messages displayed when resetting possible dosages, when Create Default Possible Dosage is No and Possible Dosages To Create is B in the National Drug File



Outpatient

Unit Dose

Non-VA Med



This drug has been set within the National Drug File to auto create two possible dosages.



Due to National Drug File settings TWO possible dosages were auto-created.








Choose from:

1 100 IO

2 200 IO




1.2.4 Most Common Dosages Report [PSS COMMON DOSAGES]


User Manual

The Most Common Dosages Report [PSS COMMON DOSAGES] option displays the most

common dosages administered over a specified time period for Unit Dose orders.

Example: Most Common Dosages Report [PSS COMMON DOSAGES] Option

Select Dosages Option: MOst Common Dosages Report

This report displays common dosages of Dispense Drugs for Unit Dose orders

based on the time frame entered. Unit Dose orders without a Dosage Ordered

are not included on this report.

If there are multiple Dispense Drugs associated with an order, only the first

Dispense Drug of the order will print with the Dosage Ordered.

Press Return to continue, '^' to exit: <Enter>

Enter start date for gathering Dosages: T-365 (JAN 23, 2000)

Do not print Dosage if frequency is less than: (1-100): 1// 10

Because of the length of this report, and the time needed to gather the

information, this report must be queued to a printer.

DEVICE: HOME// QUEUED

DEVICE: HOME// PRINTER 1

(This report must be sent a printer)

COMMON DOSAGES REPORT STARTING FROM 01/23/00 PAGE: 1

DRUG DOSAGE FREQUENCY

------------------------------------------------------------------------------

ACETAMINOPHEN 325MG TAB U.D. 325-650MG TAB 12

650 mg 16

650MG 25

650MG TAB 66

650mg 33

ACETAMINOPHEN 500MG TAB U.D. 1000 mg 20

1000MG 11

1000MG TAB 33

1000mg 12

500-1000MG TAB 17

ALBUTEROL 0.5% INHL SOLN 0.5% NEB SOLN 10

0.5CC SOLN 40

0.5ML SOLN 12

ALBUTEROL 90MCG 200D ORAL INHL 2 PUFFS 52

2 puffs 17

ALLOPURINOL 300MG TAB U.D. 300MG TAB 12

ALOH/MGOH/SIMTH XTRA STRENGTH LIQ 30CC 11

30CC SUSP 15

30cc 25

AMOXICILLIN 500/CLAV K 125MG TAB 500/125MG TAB 13

ASPIRIN 325MG EC TAB U.D. 325 MG 11

325MG EC TAB 80

ASPIRIN 325MG TAB U.D. 325 MG 10

325 mg 10

325MG TAB 17

ASPIRIN 81MG CHEW TAB 81MG TAB 16


User Manual

ATENOLOL 25MG TAB 25MG TAB 17

ATENOLOL 50MG TAB 50MG TAB 14

AZITHROMYCIN 250MG TAB 250MG TAB 11

BISACODYL 10MG RTL SUPP 10MG SUPP 19

CARBAMAZEPINE (TEGRETOL) 100MG CHEW TAB 100MG TAB 11

CARBAMAZEPINE (TEGRETOL) 200MG TAB 200MG TAB 11

CASANTHRANOL 30/DOCUSATE 100MG CAP U.D. 30/100MG CAP 24

CLOPIDOGREL BISULFATE 75MG TAB 75 mg 14

DEXAMETHASONE 4MG TAB U.D. 4MG 13

DIGOXIN (LANOXIN) 0.125MG TAB 0.125 mg 10

0.125MG 10

0.125MG TAB 23

DIGOXIN (LANOXIN) 0.25MG TAB 0.25MG 13

0.25MG TAB 27

DOCUSATE NA 100MG CAP U.D. 100 MG 11

100 mg 19

100MG 11

100MG CAP 40

DROPERIDOL 5MG/2ML INJ 1/4-1/2CC INJ 19

FELODIPINE 5MG SA TAB U.D. 5MG SA TAB 10

FERROUS SULFATE 325MG TAB 325MG TAB 31

FLUNISOLIDE 250MCG 100D ORAL INHL 2 PUFFS 18

2 puffs 12

FOLIC ACID 1MG TAB U.D. 1 mg 21

1MG TAB 19

(Report continues)

1.2.5 Noun/Dosage Form Report [PSS DOSE FORM/NOUN REPORT]

The Noun/Dosage Form Report [PSS DOSE FORM/NOUN REPORT] option displays the

Dosage Forms, along with their associated Nouns and package use identifiers. It also displays the

Local Possible Dosage created by the software based on the Nouns and Instructions of each

Dosage Form. Example: Noun/Dosage Form Report [PSS DOSE FORM/NOUN REPORT] Option

Select Dosages Option: NOUN/Dosage Form Report

This report shows the Dosage Forms and Nouns, along with the package use for

each Noun and the resulting Local Possible Dosage.

DEVICE: HOME// <Enter> TELNET DEVICE

Dosage Form [RxNorm Name] Dispense Units per Dose PAGE: 1

Noun(s) Package-->Local Possible Dosage

-----------------------------------------------------------------------------


User Manual

ACCESS PIN

(No Nouns)

ADAPTER (1)

ADAPTER IO--> 1 ADAPTER

AEROSOL [Aerosol] (1)

PUFF(S) IO--> 1 PUFF

AEROSOL,ORAL (1)

PUFF(S) IO--> 1 PUFF

AEROSOL,RTL (1)

APPLICATORFUL IO--> 1 APPLICATORF

UL

(Report Continues)

1.2.6 Review Dosages Report [PSS DOSAGE REVIEW REPORT]

The Review Dosages Report [PSS DOSAGE REVIEW REPORT] option shows the Possible

Dosages and Local Possible Dosages for selected Dispense Drugs. If the strength of the drug

does not match the strength of the VA Product to which it is matched to, it will be noted on the

report. The VA Product Name will be displayed, as well as the Dose Unit and Numeric Dose for

Local Possible Dosages.

Example: Review Dosages Report [PSS DOSAGE REVIEW REPORT] Option

Select Dosages Option: REVIEW Dosages Report

Select one of the following:

A ALL

S SELECT A RANGE

Print Report for (A)ll or (S)elect a Range: S// ALL

This report will be for all drugs.

Is this correct? Y// <ENTER> ES

This report is designed for 132 column format!

DEVICE: HOME// <ENTER>

Dosage report for all drugs Outpatient Expansion PAGE: 1

---------------------------------------------------------------------------------------------

(5573) 10% FREE AMINE SOLUTION W/O ELECT. *N/F* Inactive Date:

(106) 5,5-DIPHENYLHYDANTOIN (PHENYTOIN) PWDR Inactive Date:

(1196) A & D OINT Inactive Date:

Strength: Units: Application Package: OXU

Possible Dosages: (None)

Local Possible Dosages:

SMALL AMOUNT

Numeric Dose: Dose Unit:

Package: IO

MODERATE AMOUNT


Package: IO


User Manual

LIBERAL AMOUNT


Package: IO

(108) ABACAVIR SO4 600MG/LAMIVUDINE 300MG TAB Inactive Date:

Strength: Units: Application Package: OUX



1 TABLET

Numeric Dose: 1 Dose Unit: TABLET(S)

Package: IO

2 TABLETS


Package: IO

(192) ABACAVIR SULFATE 100MG/5ML ORAL SOLN Inactive Date:

Strength: 100 Units: Application Package: OUX

Possible Dosages:

Dispense Units Per Dose: 1 Dose: 100MG/5ML Package: I




1 TEASPOONFUL

Numeric Dose: 100 Dose Unit: MILLIGRAM(S)

Package: IO

2 TEASPOONFULS

Numeric Dose: 200 Dose Unit: MILLIGRAM(S) Package: IO

1 TABLESPOONFUL


2 TABLESPOONFULS


(4738) ABDOMINAL PAD 7 1/2 X 8 STERILE Inactive Date:

(196) ABSORBASE TOP OINT Inactive Date:

Strength: Units: Application Package: OUX



SMALL AMOUNT

Numeric Dose: Dose Unit: Package: IO

MODERATE AMOUNT


LIBERAL AMOUNT


Package: IO

(200) ACARBOSE 25MG TAB Inactive Date:

Strength: 25 Units: MG Application Package: OUX

Possible Dosages:

Dispense Units Per Dose: 1 Dose: 25MG Package: IO

1 TABLET

Local Possible Dosages: (None)

(2736) ACCU-CHEK AVIVA 1-2 CONTROL SOLN Inactive Date:

(203) ACEBUTOLOL HCL 200MG CAP Inactive Date:

Strength: 200 Units: MG Application Package: OUX

Possible Dosages:


1 CAPSULE


2 CAPSULES



User Manual

(2716) ACETAMINOPHEN 100MG/ML (SF) ORAL SUSP Inactive Date:

Strength: 100 Units: Application Package: OUX

Possible Dosages:




100MG (1ML)

Numeric Dose: 100 Dose Unit: MILLIGRAM(S) Package: O

200MG (2ML)

Numeric Dose: 200 Dose Unit: MILLIGRAM(S) Package: O

(2587) ACETAMINOPHEN 120MG/5ML LIQUID Inactive Date:

Strength: 120 Units: Application Package: UOX

Possible Dosages:

Dispense Units Per Dose: 1 Dose: 120MG/3.75ML Package: I

Dispense Units Per Dose: 2 Dose: 240MG/7.5ML Package: I


Note: Strength of 120 does not match NDF strength of 160.

VA PRODUCT MATCH: ACETAMINOPHEN 160MG/5ML ELIXIR

(Report Continues)

1.2.7 Local Possible Dosages Report [PSS LOCAL POSSIBLE DOSAGES]

The Local Possible Dosages Report [PSS LOCAL POSSIBLE DOSAGES] option identifies

drugs with Local Possible Dosages that have missing data in either the Numeric Dose or Dose

Unit fields. This data needs to be populated if Dosage checks are to be performed, when that

Local Possible Dosage is selected for an order.

This report can be printed for all drugs in the local drug file that have Local Possible Dosages

defined or only the drugs that have Local Possible Dosages defined with missing data in either

the NUMERIC DOSE sub-field (#5) of the LOCAL POSSIBLE DOSAGES multiple (#904) in

DRUG file (#50) or DOSE UNIT sub-field (#4) of the LOCAL POSSIBLE DOSAGES multiple

(#904) in DRUG file (#50). If no missing data is found the report will display ‘No Local Possible

Dosage missing data found.’

If the strength of the drug does not match the strength of the VA Product to which it is matched

to, it will be noted on the report.

Note: This report is written for a 132 column format.

Drugs that meet the following criteria will be screened out from this report.

• Inactive

• Not Matched to NDF

• Associated with dosage form that is excluded from dosage checks and matched to a VA

Product that has the OVERRIDE DF DOSE CHK EXCLUSION field (#31) of the VA

PRODUCT file (#50.68) set to ‘No’

<< Strength mismatch notice


User Manual

• Associated with dosage form that is NOT excluded from dosage checks, but is matched

to a VA Product that has the OVERRIDE DF DOSE CHK EXCLUSION field (#31) of

the VA PRODUCT file (#50.68) set to ‘Yes’

• Drug is marked as a supply item (‘S’ in DEA, SPECIAL HDLG field (#3) of the DRUG

file (#50) or assigned a VA Drug Class starting with an ‘XA’)

• Drug does not have any Local Possible Dosages defined

Example: Local Possible Dosages Report [PSS LOCAL POSSIBLE DOSAGES] Option for Only Local Possible Dosage with Missing Data

Select Enhanced Order Checks Setup Menu Option: LOCAL POssible Dosages Report

This report will print Local Possible Dosage information only for Drugs for

which Dosage Checks can be performed. Drugs that are inactive, marked and/or

classed as supply items, not matched to NDF or excluded from dosage checks (due

to dosage form or VA Product override) will not be included in this report.

Users will be able to print Local Possible Dosage information for all eligible

drugs or only for drugs with missing data in the Numeric Dose and Dose Unit

fields. These two fields must be populated to perform Dosage Checks for a Local

Possible Dosage selected when placing a Pharmacy order.


A ALL LOCAL POSSIBLE DOSAGES

O ONLY LOCAL POSSIBLE DOSAGE WITH MISSING DATA

Enter 'A' for All, 'O' for Only: O// <ENTER> NLY LOCAL POSSIBLE DOSAGE WITH MISSING DATA



Local Possible Dosages Report (Missing Data Only) PAGE: 1

-----------------------------------------------------------------------------------------

(811) GELUSIL TABLETS

Strength: Units: Application Package: UOX


1 TABLET

Numeric Dose: Dose Unit: Package: O

2 TABLET(S)

Numeric Dose: Dose Unit: Package: O

VA PRODUCT MATCH: AL OH 200MG/MG OH 200MG/SIMETHICONE 25MG TAB,CHEWABLE

(156) GUAIFENESIN 50MG/5ML SYRUP

Strength: 50 Units: MG/5ML Application Package: OUX


1 TEASPOONFUL

Numeric Dose: Dose Unit: MILLIGRAM(S) Package: IO

2 TEASPOONFUL(S)


Note: Strength 50 does not match NDF strength of 100.

VA PRODUCT MATCH: GUAIFENESIN 100MG/5ML SYRUP

1.2.8 Request Change to Dose Unit [PSS DOSE UNIT REQUEST]

The Request Change to Dose Unit [PSS DOSE UNIT REQUEST] option is provided for users to

request additions or changes to the DOSE UNITS file (#51.24). The request is directed to an

Outlook mail group ([email protected]) that will review and act on

mailto:[email protected]


User Manual

the requests. A copy of the request is also sent to the user’s VistA email account. The following

information about the request will be needed:

• Dose Unit to be added or modified (required)

• References or Reason for Request (required)

If the user is not ready to send the request, answering ‘No’ at the transmit prompt will send the

request just to the user’s VistA email account. Once ready to send the request and if no changes

are needed, the VistA email message can be retrieved and forwarded to the Outlook mail group

([email protected]). If the VistA email message is no longer

available for retrieval, the request must be reentered and transmitted. The option will use

whatever editor (line or screen) the user has defined for “Preferred editor” in the NEW PERSON

file (#200).

Example: Request Change to Dose Unit [PSS DOSE UNIT REQUEST] Option

Select Enhanced Order Checks Setup Menu Option: REQUEST CHANGE TO DOSE UNIT


N New Dose Unit

C Change to Existing Dose Unit

Request New Dose Unit or Change existing Dose Unit: N// <ENTER> ew Dose Unit

Enter Dose Unit name: GRAIN(S)

You must now enter a reason or references for this request.

Press Return to continue, '^' to exit: <ENTER>

==[ WRAP ]==[ INSERT ]====< References/Reason for Request >==[ <PF1>H=Help ]====

Valid Dose Unit missing from file.

<=======T=======T=======T=======T=======T=======T=======T=======T=======T>======

Do you want to save changes? y

Transmit Dose Unit Request? Y// <ENTER> ES

Mail message transmitted for review.


Example: Request Change to Dose Unit [PSS DOSE UNIT REQUEST] Option Request Email

Subj: Dose Unit Request [#89442] 05/28/08@12:51 4 lines

From: PHARMACIST, ONE In 'IN' basket. Page 1

-------------------------------------------------------------------------------

Request New Dose Unit:

GRAIN(S)

Valid Dose Unit missing from file.

Enter message action (in IN basket): Ignore// QD Query Detailed

Subj: Dose Unit Request [#89442] 05/28/08@12:51 4 lines

From: PHARMACIST, ONE In 'IN' basket.

Local Message-ID: [email protected] (2 recipients)


User Manual

PHARMACIST, ONE Last read: 05/28/08@12:52 [First read: 05/28/08@12:51]

[email protected] Sent: 05/28/08@12:51 Time: 1 second

Message ID: [email protected]

Enter message action (in IN basket): Ignore//

Example: REQuest Change to Dose Unit [PSS DOSE UNIT REQUEST] Option

Select Dosages Option: REQuest Change to Dose Unit


N New Dose Unit

C Change to Existing Dose Unit

Request New Dose Unit or Change existing Dose Unit: N// Change to Existing Dose

Unit

Select DOSE UNITS: ??

Choose from:

ANTI-XA UNIT *** This is actually stored in the DOSE UNIT file in Mixed Case

APPLICATION(S)

APPLICATORFUL(S)

BAR(S)

CAP/TAB

CAPLET(S)

CAPSULE(S)

CENTIMETER(S)

DROP(S)

EACH

ELISA UNIT(S)

ENEMA(S)

FILM(S)

GRAM(S)

IMPLANT(S)

INCH(ES)

INHALATION(S)

INSERT(S)

LITER(S)

^

Select DOSE UNITS:

1.2.9 Lookup Dosing Check Info for Drug [PSS DRUG DOSING LOOKUP]

This option displays all of the information related to Dosing Order Checks for the selected entry

from the DRUG file (#50). Based on the data displayed, the option informs the user whether or

not the drug is eligible or not eligible for Dosing Order Checks.

No Dosing Order Checks will be performed on supply items. A supply item is identified by

either a VA Drug Class code that begins with an ‘XA’ or that contains an ‘S’ in the DEA,

SPECIAL HDLG field (#3) in the DRUG file (#50).

A dosage form is excluded from Dosing Order Checks if the EXCLUDE FROM DOSAGE

CHECKS field (#11) in the DOSAGE FORM file (#50.606) is set to ‘Yes’. If the drug ordered is

associated with a dosage form that is excluded from Dosing Order Checks and the value in the

OVERRIDE DF DOSE CHK EXCLUSION field (#31) in the VA PRODUCT file (#50.68) is

blank or set to ‘No’ for the VA Product the drug is matched to, no Dosing Order Checks will be


User Manual

performed. If the drug ordered is associated with a dosage form that is NOT excluded from

Dosing Order Checks and the value in the OVERRIDE DF DOSE CHK EXCLUSION field

(#31) in the VA PRODUCT file (#50.68) is set to ‘Yes’ for the VA Product that the drug is

matched to, no Dosing Order checks will be performed.

The table below shows all the different combinations of values for the EXCLUDE FROM

DOSAGE CHECK field (#11) in the DOSAGE FORM file (#50.606) and the OVERRIDE DF

DOSE CHK EXCLUSION field (#31) in the VA PRODUCT file (#50.68) and whether or not

those combinations result in a Dosing Order Check being performed.

Dosage Form Field –

EXCLUDE FROM

DOSAGE CHECKS

VA Product Field –

OVERRIDE DF DOSE

CHK EXCLUSION

Dosing Order Check

Performed? (Y/N)

Yes No No

Yes Yes Yes

No No Yes

No Yes No

If a drug is not matched to NDF, a GCNSEQNO cannot be obtained to identify the drug to FDB

in order to perform a Dosing Order Check. In some cases, the drug may be matched to NDF, but

the VA Product, to which it is matched, may not have a GCNSEQNO assigned. In both of these

cases, the drug will be ineligible for Dosing Order Checks.

The information provided in the first section of the display is from the DRUG file (#50) and VA

PRODUCT file (#50.68) (if the drug is matched to NDF). If no GCNSEQNO is found, ‘None’

will display in lieu of the number. Whether or not the drug is eligible or not eligible for Dosing

Order Checks is displayed at the bottom of this section.

The second section displays all dosage information such as strength, unit, possible dosages, and

local possible dosages that has been defined for the drug selected.

The third and final section displays dosage information from First Databank (FDB). It will show

all route and dose units found in FDB dosing records for the drug and whether or not a weight or

BSA value is required for a dosage order check to be performed. If a drug is not eligible for

Dosing Order Checks, no FDB data will display.

If some of the dosing records for a drug require a weight or BSA and others do not, the option

will display a ‘Yes’ with a list of age range(s) for those records that do require a weight or BSA

and a ‘No’ with a list of age range(s) for those records that do not require a weight or BSA. The

age will be expressed in days. Age ranges will be displayed in ascending order using the first

number in the range. Age ranges with the same first number will display in random order. The

corresponding FDB dose type (MAINTENANCE DOSE or SINGLE DOSE) and FDB dose

route will print next to the age range in parenthesis.

If the vendor database cannot be reached, the following text in lieu of all FDB information for

the drug will be displayed in the third and final section:


User Manual

Vendor database cannot be reached. FDB dosing information could not be retrieved at this

time.

Example 1: Drug Eligible for Dosage Checks

Select Dosages Option: LOOKUP Dosing Check Info for Drug

Select DRUG GENERIC NAME: ACETAMINO

1 ACETAMINOPHEN 160MG/5ML ELIXIR CN103

2 ACETAMINOPHEN 325MG TAB CN103

3 ACETAMINOPHEN 325MG/COD 30MG TAB CN101

4 ACETAMINOPHEN 650MG SUPP CN103

5 ACETAMINOPHEN 650MG TAB CN103 RESTRICTED TO ORTHOPEDI

CS


CHOOSE 1-5: 1 ACETAMINOPHEN 160MG/5ML ELIXIR CN103

ACETAMINOPHEN 160MG/5ML ELIXIR (GCNSEQNO: 004481)

=====================================================================

VA PRODUCT NAME: ACETAMINOPHEN 160MG/5ML ELIXIR

NDF DOSAGE FORM: ELIXIR

DEA, SPECIAL HDLG: VA DRUG CLASS: CN103

EXCLUDE DOSAGE FORM FROM DOSAGE CHECKS: NO

OVERRIDE DOSAGE FORM DOSE CHECK EXCLUSION FOR VA PRODUCT: NO

***DRUG ELIGIBLE FOR DOSAGE CHECKS***

---------------------------------------------------------------------------------------------

------------------------

Strength: 160 Unit:

POSSIBLE DOSAGES:

DISPENSE UNITS PER DOSE: 1 DOSE: 160MG/5ML PACKAGE: I


DISPENSE UNITS PER DOSE: 2 DOSE: 320MG/10ML PACKAGE: I



LOCAL POSSIBLE DOSAGE: 1 TEASPOON PACKAGE: O


NUMERIC DOSE: 160 DOSE UNIT: MILLIGRAM(S)

LOCAL POSSIBLE DOSAGE: 2 TEASPOON PACKAGE: O



LOCAL POSSIBLE DOSAGE: 1 TABLESPOON PACKAGE: O



LOCAL POSSIBLE DOSAGE: 2 TABLESPOON PACKAGE: O



---------------------------------------------------------------------------------------------

------------------------

FDB ROUTES: ORAL

FDB DOSE UNITS: ML, MG

BSA REQUIRED FOR DOSAGE CHECKS: NO

WEIGHT REQUIRED FOR DOSAGE CHECKS:

YES for Age in Days: 0-29 (MAINTENANCE DOSE, ORAL)

0-29 (SINGLE DOSE, ORAL)


30-90 (MAINTENANCE DOSE, ORAL)





NO for Age in Days: 4380-40150 (MAINTENANCE DOSE, ORAL)




User Manual

Example 2: Drug Not Eligible for Dosage Checks

Select DRUG GENERIC NAME: hydrocortisone

1 HYDROCORTISONE 0.1% CREAM DE200

2 HYDROCORTISONE 0.5% CREAM DE200

3 HYDROCORTISONE 0.5% OINT DE200

CHOOSE 1-3: 2 HYDROCORTISONE 0.5% CREAM DE200

HYDROCORTISONE 0.5% CREAM (GCNSEQNO: 007543)

====================================================================

VA PRODUCT NAME: HYDROCORTISONE 0.5% CREAM,TOP

NDF DOSAGE FORM: CREAM,TOP

DEA, SPECIAL HDLG: VA DRUG CLASS: DE200

EXCLUDE DOSAGE FORM FROM DOSAGE CHECKS: YES

OVERRIDE DOSAGE FORM DOSE CHECK EXCLUSION FOR VA PRODUCT: NO

***DRUG NOT ELIGIBLE FOR DOSAGE CHECKS***

---------------------------------------------------------------------------------------------

---------------------

Strength: Unit:

POSSIBLE DOSAGES:


---------------------------------------------------------------------------------------------

------------------------

FDB ROUTES: TOPICAL

FDB DOSE UNITS:

BSA REQUIRED FOR DOSAGE CHECKS:

WEIGHT REQUIRED FOR DOSAGE CHECKS:


1.2.10 Drug Names with Trailing Spaces Report [PSS TRAILING SPACES REPORT]

This option lists all active, multi-ingredient DRUG File (#50) entries with Local Possible

Dosages defined, and whose drug name has trailing spaces. Drugs not matched to the NDF with

trailing spaces in the name will also be listed. Single ingredient entries with Local Possible

Dosages defined whose drug name has trailing spaces and are matched to a VA Product with a

non-numeric value in the STRENGTH field (#2) may also be listed on this report. If the Drug

Name is appended to the Local Possible Dosage and optional conjunction in the Computerized

Patient Record System (CPRS) order dialogues, a selection of such a dosage could cause the

conjunction plus drug name to become part of the actual Dosage, instead of just a display

enhancement. This can cause the Dosage check to fail, and that extra text could come to

pharmacy as part of the Dosage in the order. These trailing spaces should be cleaned up if

possible.

For each such drug identified in the DRUG file (#50), the report will print the Internal Entry

Number and the GENERIC NAME field (#.01).

DRUG NAME TRAILING SPACES REPORT PAGE: 1

---------------------------------------------------------------------------------------------

MULTIVITAMINS W/MINERALS TAB (7987)

OXYCODONE 5MG/ACETAMINOPHEN 325MG TAB (7986)

TRETINOIN 0.04% GEL (7988)

End of Report.


User Manual

1.2.11 Manage Buprenorphine Tx of Pain Dosage Forms

[PSS BUPRENORPHINE DOSAGE FORMS]

This option allows users to manage the list of dosage forms that are utilized for Buprenorphine

containing products being used for the treatment of pain. The option leverages the XPAR

PARAMETER functionality to allow the management of the appropriate dosage forms. Two

dosage forms are delivered at the package level with patch PSS*1*219 (FILM, BUCCAL and

PATCH). Such products may be ordered by providers who do not have a detox number.

Users with access to the ‘Dosages’ [PSS DOSAGES MANAGEMENT] menu option can edit the

approved dosage forms at the system level as needed. This prevents the need for a new software

release every time a new dosage form is identified and approved for Buprenorphine containing

product in the treatment of pain. Only users with elevated or programmer privileges can edit

these parameters at the package level.

Select Dosages Option: Manage Buprenorphine Tx of Pain Dosage Forms

Dosage Forms Buprenorphine Tx of Pain may be set for the following:

5 System SYS [TEST.DAYTON.MED.VA.GOV]

10 Package PKG [PHARMACY DATA MANAGEMENT]

Enter selection: 5 System TEST.DAYTON.MED.VA.GOV

Setting Dosage Forms Buprenorphine Tx of Pain for System: TEST.DAYTON.MED.VA.G

OV

Select Sequence: ??

Select Sequence: 1

Sequence: 1// 1

Dosage Form: PATCH// PATCH

Select Sequence: 2

Sequence: 2// 2

Dosage Form: TAB// TAB

Select Sequence: 3

Are you adding 3 as a new Sequence? Yes// YES

Sequence: 3// 3

Dosage Form: FILM,BUCCAL

=================================================================================

Select Dosages Option: Manage Buprenorphine Tx of Pain Dosage Forms

Dosage Forms Buprenorphine Tx of Pain may be set for the following:

5 System SYS [TEST.DAYTON.MED.VA.GOV]

10 Package PKG [PHARMACY DATA MANAGEMENT]

Enter selection: 10 Package PHARMACY DATA MANAGEMENT

Parameters set for 'Package' may be replaced if PHARMACY DATA MANAGEMENT

is installed in this account.

Setting Dosage Forms Buprenorphine Tx of Pain for Package: PHARMACY DATA MANAG

EMENT

Select Sequence: ?


User Manual

Sequence Value

-------- -----

1 FILM,BUCCAL

2 PATCH

3 FILM,SUBLINGUAL

Select Sequence: 4

Are you adding 4 as a new Sequence? Yes// YES

Sequence: 4// 4

Dosage Form: TAB

1 TAB

2 TAB (DELAYED RELEASE)

3 TAB,BUCC,SA

4 TAB,BUCCAL

5 TAB,CHEWABLE

Press <Enter> to see more, '^' to exit this list, OR

CHOOSE 1-5: 1 TAB

Select Sequence:

1.3 Drug Enter/Edit [PSS DRUG ENTER/EDIT]

The Drug Enter/Edit [PSS DRUG ENTER/EDIT] option allows users to make a new Dispense

Drug entry into the DRUG file (#50) or to make changes to existing DRUG file (#50) Dispense

Drug entries. This option consolidates entries for all Pharmacy packages if the user possesses the

proper package key. It will also allow the user to match Dispense Drugs to corresponding

NATIONAL DRUG and Pharmacy Orderable Item entries and to tie the Dispense Drug to a

DRUG TEXT file (#51.7) entry. Dispense Drug formulary status is designated via this option

and formulary alternatives may be designated for non-formulary Dispense Drug entries.

Furthermore, addition of identically named IV ADDITIVES and IV SOLUTIONS from the Drug

Enter/Edit [PSS DRUG ENTER/EDIT] option is allowed when linking an additive or solution to

the drug.

Example – Identically Named Additives

AN IV ITEM? Yes// Y (Yes)

Edit Additives or Solutions:


A ADDITIVES

S SOLUTIONS

Enter response: ADDITIVES

CEFAZOLIN SOD 1GM INJ currently linked to the following IV Additives:

1. TESTDRUG Additive Strength: 10 MG

2. TESTDRUG Additive Strength: 5 GM

3. TESTDRUG Additive Strength: 12 GM

4. TESTDRUG Additive Strength: 12.5 GM

Select 1-4 from list above or type 'NEW' to link to a new IV Additive: NEW


User Manual

Select IV ADDITIVES PRINT NAME: TESTDRUG

Lookup: PRINT NAME

1 TESTDRUG Additive Strength: 10 MG

2 TESTDRUG Additive Strength: 5 GM


4 TESTDRUG Additive Strength: 12.5 GM

CHOOSE 1-4:

Are you adding 'TESTDRUG' as a new IV ADDITIVES (the 78TH)? No// Y

(Yes)

Example - New Solution

AN IV ITEM? Yes// (Yes)



A ADDITIVES

S SOLUTIONS

Enter response: SOLUTIONS

CEFAZOLIN SOD 1GM INJ currently linked to IV Solutions:

1. 0.9% SODIUM CHLORIDE 300 ML




Select 1-4 from list above or type 'NEW' to link to a new IV Solution: NEW

Select IV SOLUTIONS PRINT NAME: 0.9% SODIUM CHLORIDE

Lookup: PRINT NAME

1 0.9% SODIUM CHLORIDE 250 ML





Press <RETURN> to see more, '^' to exit this list, '^^' to exit all

lists, OR

CHOOSE 1-5:

Are you adding '0.9% SODIUM CHLORIDE' as a new IV SOLUTIONS (the 33RD)? No// Y

(Yes)

Dosages created as the result of National Drug File matching or auto creation of dosages may be

reviewed and edited via this option.

Outpatient Pharmacy designated Dispense Drug entries may be marked or unmarked as a LAB

MONITOR or CLOZAPINE DRUG. This will allow lab values to print on the Outpatient Action

Profile for the designated drug and provide lab monitor checks for Clozapine drugs during the

medication order entry process.

The Drug Enter/Edit [PSS DRUG ENTER/EDIT] option allows the user to enter a dosage in a

language other than English. PDM does not translate English terms into another language;

instead, it allows the user to enter a translation of a term. If a value has not been entered in the

OTHER LANGUAGE DOSAGE NAME sub-field (#3) of the LOCAL POSSIBLE DOSAGE

multiple (#904) of the DRUG file (#50), PDM defaults to the value entered in the LOCAL


User Manual

POSSIBLE DOSAGE sub-field (#.01) of the LOCAL POSSIBLE DOSAGE multiple (#904) of

the DRUG file (#50). If no values exist in the LOCAL POSSIBLE DOSAGE sub-field (#.01) of

the LOCAL POSSIBLE DOSAGE multiple (#904) of the DRUG file (#50) and OTHER

LANGUAGE DOSAGE NAME sub-field (#3) of the LOCAL POSSIBLE DOSAGE multiple

(#904) of the DRUG file (#50), the system will not display default values for those fields during

CPRS or Outpatient Pharmacy prescription order entry processing. However, when building the

SIG, Outpatient Pharmacy will default to the value the user input during order entry. Patch PSS*1*61 adds a new code “F” for NON REFILLABLE to the DEA, SPECIAL HDLG field (#3) of the DRUG file (#50), which will allow sites to mark drugs other than controlled substances or clozapine drugs as NON REFILLABLE. Patch PSS*1*192 adds new fields EPHARMACY BILLABLE (#84), EPHARMACY BILLABLE (TRICARE) (#85), EPHARMACY BILLABLE (CHAMPVA) (#86) of the DRUG file (#50) to indicate that the drug file entry is electronically billable. These fields replace functionality previously provided by the DEA, Special HANDLING field. Patch PSS*1*214 adds a message to be displayed if the user exits the option and all three EPHARMACY BILLABLE fields are blank and the drug is not inactive. The option is given to return and answer the billable questions. Patch PSS*1*192 adds a new field Sensitive Diagnosis Drug (#87) of the DRUG file (#50) to indicate that the drug is used to treat certain conditions that are deemed “sensitive”. Specifically, the VA may not disclose any information on the following diseases: HIV, drug abuse, alcohol abuse, or sickle cell anemia without a signed consent from the patient. If a drug file entry is marked as a Sensitive Diagnosis Drug, a signed Release of Information (ROI) needs to be on file in VistA for prescriptions for the drug to be billable. This functionality works in conjunction with ROI modifications made in IB*2*384 and PSS*1*131.

Patch PSS*1*156 adds the new OPAI multiple (#906) to the DRUG file (#50), which will allow

prescription orders for a certain drug to be sent to a specific Automated Dispensing Device

(ADD). Setup can be done by division such that a drug is linked to a specific ADD. This

functionality works in conjunction with PSO*7*354.

The sub-file contains the following new fields:

• DIVISION - This is the division associated with the ADD for the drug. This field is a

pointer to the OUTPATIENT SITE file (#59).

• WINDOW DNS NAME - This field is a pointer to the PHARMACY AUTOMATED

DISPENSING DEVICES file (#52.53). Orders with a route of WINDOW will be sent to

this ADD.

• MAIL DNS NAME - This field is a pointer to the PHARMACY AUTOMATED

DISPENSING DEVICES file (#52.53). Orders with a route of MAIL will be sent to this

ADD.

The Drug Enter/Edit [PSS DRUG ENTER/EDIT] option was modified to add the new fields

from the DRUG file (#50).


User Manual

DEA Special Handling Code

Sites will need to determine all the nutritional supplements in their DRUG file (#50) and mark

the DEA, SPECIAL HDLG field (#3) entry for all of their nutritional supplements drug file

entries with an “N”. They will also need to mark any entries that may be third party reimbursable

as billable. Usually only Rx Only nutritional supplements are third party reimbursable.

Select OPTION NAME: DRUG ENTER/EDIT PSS DRUG ENTER/EDIT Drug Enter/Edit

Drug Enter/Edit

Select DRUG GENERIC NAME: TRAZO

Lookup: GENERIC NAME

1 TRAZODONE 100MG TAB N/F

2 TRAZODONE 50MG TAB

CHOOSE 1-2: 1 TRAZODONE 100MG TAB N/F

*******************************************************************************


Outpatient

Non-VA Med

GENERIC NAME: TRAZODONE 100MG TAB//

VA CLASSIFICATION:

DEA, SPECIAL HDLG: 6// ?

ANSWER MUST BE 1-6 CHARACTERS IN LENGTH

THE SPECIAL HANDLING CODE IS A 2 TO 6 POSTION FIELD. IF APPLICABLE,

A SCHEDULE CODE MUST APPEAR IN THE FIRST POSITION. FOR EXAMPLE,

A SCHEDULE 3 NARCOTIC WILL BE CODED '3A', A SCHEDULE 3 NON-NARCOTIC WILL BE

CODED '3C' AND A SCHEDULE 2 DEPRESSANT WILL BE CODED '2L'.

THE CODES ARE:

0 MANUFACTURED IN PHARMACY

1 SCHEDULE 1 ITEM

2 SCHEDULE 2 ITEM

3 SCHEDULE 3 ITEM

4 SCHEDULE 4 ITEM

5 SCHEDULE 5 ITEM

6 LEGEND ITEM

9 OVER-THE-COUNTER

L DEPRESSANTS AND STIMULANTS

A NARCOTICS AND ALCOHOLS

P DATED DRUGS

I INVESTIGATIONAL DRUGS

M BULK COMPOUND ITEMS

C CONTROLLED SUBSTANCES - NON NARCOTIC

R RESTRICTED ITEMS

S SUPPLY ITEMS

B ALLOW REFILL (SCH. 3, 4, 5 ONLY)

W NOT RENEWABLE

F NON REFILLABLE

N NUTRITIONAL SUPPLEMENT

K NOT RENEWABLE (BY TELEPHONE)


DEA, SPECIAL HDLG field (#3) effects on ePharmacy Billing:

• The DEA, SPECIAL HDLG field (#3) does not affect Pharmacy Billing. Fields

EPHARMACY BILLABLE (#84), EPHARMACY BILLABLE (TRICARE) (#85),

EPHARMACY BILLABLE (CHAMPVA) (#86) determine billable status.

Follow these guidelines to ensure proper electronic billing:


User Manual

• If an item is to be billed, then answer YES to field EPHARMACY BILLABLE (#84) in

the DRUG file (#50).

• Sometimes it may be necessary to make exceptions for electronic billing for drugs

ordered for TRICARE or CHAMPVA eligible patients. Fields EPHARMACY

BILLABLE (TRICARE) (#85) and EPHARMACY BILLABLE (CHAMPVA) (#86) in

the DRUG file (#50) will allow drugs to be marked as billable or non-billable for

TRICARE or CHAMPVA, regardless of how the EPHARMACY BILLABLE (#84) field

is answered.

• Electronic billing for drugs ordered for TRICARE and CHAMPVA eligible patients will

be determined by the EPHARMACY BILLABLE (#84) field when the fields

EPHARMACY BILLABLE (TRICARE) (#85), EPHARMACY BILLABLE

(CHAMPVA) (#86) are not answered.

• In the following example, the drug would be billable for a VETERAN, billable for

TRICARE and non-billable for CHAMPVA:

ePharmacy Billable: YES//

ePharmacy Billable (TRICARE):

ePharmacy Billable (CHAMPVA): NO//

. .Note: The NDF option, Rematch/Match Single Drugs, screens out those items with a

DEA, SPECIAL HDLG code of “0”, “I”, or “M”. When sites receive NDF data updates that

cause one of these items to be unmatched from NDF, they cannot use the Rematch/Match Single

Drugs option to rematch if they have added “0”, “I”, or “M” to drugs like Antiretrovirals,

Disulfiram, Naltrexone, or Methadone for maintenance or detox. Sites can either:

1. Rematch to NDF using another option, or

2. Remove the DEA, SPECIAL HDLG code, use the Rematch/Match Single Drugs

option, and then add the DEA, SPECIAL HDLG code back in.

Patch PSS*1*90 adds a new multiple field to the DRUG file (#50) to store the latest National

Drug Code (NDC) numbers that have been dispensed at window as well as by CMOP for a

specific division. This way, when the next prescription is entered by the division for the same

drug, the last used NDC is automatically retrieved from this new multiple, saved in the

PRESCRIPTION file (#52), and sent to the third party payer through ECME. This field is

populated automatically and does not require user input. Below is the multiple field and the

fields under it:

32 NDC BY OUTPATIENT SITE

.01 - OUTPATIENT SITE

1 - LAST LOCAL NDC

2 - LAST CMOP NDC

DAW CODE field effects on ePharmacy Billing:


User Manual

Patch PSS*1*90 adds a new DAW CODE field (#81) to the DRUG file (#50). DAW stands for

Dispense as Written, and refers to a set of ten NCPDP codes (0-9) that tells third party payers

why a brand or generic product was selected to fill a prescription. See table below.

DAW Code DAW Description

0 No Product Selection Indicated

1 Substitution Not Allowed by Prescriber

2 Substitution Allowed-Patient Requested Product Dispensed

3 Substitution Allowed-Pharmacist Selected Product Dispensed

4 Substitution Allowed-Generic Drug Not in Stock

5 Substitution Allowed-Brand Drug Dispensed as a Generic

6 Override

7 Substitution Not Allowed-Brand Drug Mandated by Law

8 Substitution Allowed-Generic Drug Not Available in Marketplace

9 Other

Since the VA primarily uses generic products, this has not been a major issue to date. The DAW

CODE field (#81) default is 0, which means the physician did not specify whether to dispense a

generic or brand name product. We anticipate getting some rejections from third parties for cases

where we still dispense branded products, even though a generic is available in the marketplace.

Our use of Coumadin® instead of generic Warfarin is one example.

DAW codes are typically set for individual prescriptions, but can be set at the DRUG file (#50)

level as well. An example scenario of each is given below.

Example: Setting the DAW CODE at the Prescription Level

If you are informed that a prescription for Coumadin® was rejected for DAW reasons, you might

try changing the DAW CODE of the prescription and resubmitting. The change can be made

through the Patient Prescription Processing option or the Edit Prescriptions option in Outpatient

Pharmacy V. 7.0. The DAW CODE will display for ePharmacy prescriptions. For original fills,

this information can be edited by selecting screen field 21. For refills, the user must select screen

field 20 (Refill Data), then select the refill number to be edited; the “DAW CODE:” prompt

displays after the “DIVISION:” prompt. In the case of the Coumadin® reject, you may try

changing the field to a 5 or a 1, then resubmitting to see if the claim gets processed. Both 5 and 1

are appropriate choices for the VA setting. Whether or not a claim will get rejected for these

reasons and which code to use will vary from third party to third party. We are using brand name

products, but are not charging for brand name products. The most common DAW codes are

explained as follows:

#1: Physician stipulates that a particular brand be used.

#5: A brand name product is dispensed even though a generic product exists. Patient will be

charged at the generic price.


User Manual

Example: Setting the DAW CODE at the Drug File Level

If you are told that almost every prescription for Coumadin® is being rejected, you may choose

to make the change at the DRUG file (#50) level. Editing the DAW Code field (#81) in the

DRUG file (#50) for the Coumadin® entry will make a global change, such that each ePharmacy

prescription filled for that product will use the DAW code you specify.

Note: Ask your Pharmacy ADPAC to make the change at the DRUG file (#50) level.

When using the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option, a warning message is

displayed if a discrepancy is found between the CS FEDERAL SCHEDULE field (#19) of the VA

PRODUCT file (#50.68) and the DEA, SPECIAL HDLG field (#3) of the DRUG file (#50). The

warning message says, "The CS Federal Schedule associated with this drug in the VA Product file

represents a DEA, Special Handling code of XX", where XX is the DEA, SPECIAL HDLG code

mapped to corresponding CS FEDERAL SCHEDULE code defined as follows (schedule I, IV and

V are identical):

CS FEDERAL SCHEDULE DEA, SPECIAL HDLG

Schedule I narcotics 1 1

Schedule II narcotics 2 2A

Schedule II non-narcotics 2n 2C

Schedule III narcotics 3 3A

Schedule III non-narcotics 3n 3C

Schedule IV narcotics 4 4

Schedule V narcotics 5 5

Patch PSS*1*129 enhances the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option to allow

editing of the NUMERIC DOSE sub-field (#5) of the LOCAL POSSIBLE DOSAGES multiple

(#904) in DRUG file (#50) and DOSE UNIT sub-field (#4) of the LOCAL POSSIBLE

DOSAGES multiple (#904) in DRUG file (#50).

If any of the following conditions can be determined at the time of entry, the NUMERIC DOSE

sub-field (#5) of the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) and

DOSE UNIT sub-field (#4) of the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file

(#50) for any defined Local Possible Dosage will not be presented for data entry.

• Drugs associated with a dosage form that is excluded from dosage checks and the VA

Product it is matched to will have the OVERRIDE DF DOSE CHK EXCLUSION field

(#31) ) in the VA PRODUCT file (#50.68) file set to ‘No’

• Drug associated with a dosage form that is NOT excluded from dosage checks, but the

VA Product that it is matched to will have the OVERRIDE DF DOSE CHK

EXCLUSION field (#31) set to ‘Yes’

• Drug is marked as a supply item (‘S’ in DEA, SPECIAL HDLG field (#3) or assigned a

VA Drug Class starting with an ‘XA’).


User Manual

A warning will be provided if the DRUG file (#50) strength does not match the VA PRODUCT

file (#50.68) strength to which it is matched.

Although ineligible for dosage checks, when editing a Local Possible Dosage for an inactive

drug or a drug not matched to NDF, the NUMERIC DOSE sub-field (#5) of the LOCAL

POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) and DOSE UNIT sub-field (#4) of

the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) will be displayed to the

user for data entry.

PSS*1*200 enhances the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option to display Copay

Tier sub-field (#.01) and Copay Effective Date sub-field (#1) of the VA PRODUCT file (#50.6)

to accommodate the nationally controlled values for the Fixed Medication Copay Tier (FMCT)

data. FMCT information is used to determine the copay amount for veterans not exempt from

paying copayments for their prescriptions. There are 3 mandated Tiers, Tier 1, Tier 2 and Tier

3. These tiers will be displayed on the selection list for Pharmacy Products and within the details

of an identified product. The effective date will also be displayed with the details.

Example 1: Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option (showing Strength mismatch message and new fields)

Select Pharmacy Data Management Option: DRUG

1 Drug Enter/Edit

2 Drug Interaction Management

3 Drug Text Management

CHOOSE 1-3: 1 Drug Enter/Edit

Select DRUG GENERIC NAME: ACETAMINOPHEN ELIX. 120MG/5ML 4OZ CN103

...OK? Yes// <ENTER> (Yes)

*******************************************************************************


Outpatient

Unit Dose

Non-VA Med

GENERIC NAME: ACETAMINOPHEN ELIX. 120MG/5ML 4OZ Replace <ENTER>

VA CLASSIFICATION: CN103// <ENTER>

DEA, SPECIAL HDLG: 6// <ENTER>



ePharmacy Billable (CHAMPVA):

Sensitive Diagnosis Drug:

DAW CODE: <ENTER>


Copay Tier: 2

Copay Effective Date: JUN 20, 2016

LOCAL NON-FORMULARY: <ENTER>

VISN NON-FORMULARY: <ENTER>

Select DRUG TEXT ENTRY: <ENTER>

Select FORMULARY ALTERNATIVE: <ENTER>

Select SYNONYM: 000054301050// <ENTER>

SYNONYM: 000054301050// <ENTER>

INTENDED USE: DRUG ACCOUNTABILITY// <ENTER>


User Manual

NDC CODE: 000054-3010-50// <ENTER>

Select SYNONYM: <ENTER>

MESSAGE: <ENTER>

RESTRICTION: <ENTER>

FSN: <ENTER>

NDC: 54-3010-50// <ENTER>

INACTIVE DATE: <ENTER>

WARNING LABEL SOURCE is not 'NEW'.

WARNING LABEL will be used until the WARNING LABEL SOURCE is set to 'NEW'.

WARNING LABEL: 8// <ENTER>

Current Warning labels for ACETAMINOPHEN ELIX. 120MG/5ML 4OZ



66N This medicine contains ACETAMINOPHEN. Taking more ACETAMINOPHEN than


70N Do not take other ACETAMINOPHEN containing products at the same time





Would you like to edit this list of warnings? N// <ENTER> O

ORDER UNIT: <ENTER>

PRICE PER ORDER UNIT: <ENTER>

DISPENSE UNIT: <ENTER>

DISPENSE UNITS PER ORDER UNIT: 1// <ENTER>

NCPDP DISPENSE UNIT: EACH//

NCPDP QUANTITY MULTIPLIER: 1//MAXIMUM DAYS SUPPLY: 365// ?

This is the maximum number day supply for this drug.

MAXIMUM DAYS SUPPLY: 365// ?


points to ACETAMINOPHEN 160MG/5ML ELIXIR in the National Drug file.




Do you wish to match/rematch to NATIONAL DRUG file? No// <ENTER> (No)

Just a reminder...you are editing ACETAMINOPHEN ELIX. 120MG/5ML 4OZ.



Please Note: Strength of drug does not match strength of VA Product it is matched

to.

Press Return to Continue: <ENTER>


POSSIBLE DOSAGES:

DISPENSE UNITS PER DOSE: 2 DOSE: 240 MG/5 ML PACKAGE: I


User Manual


LOCAL POSSIBLE DOSAGE: ONE TEASPOONFUL PACKAGE: O



STRENGTH: 120// <ENTER>

Select DISPENSE UNITS PER DOSE: <ENTER>


Select LOCAL POSSIBLE DOSAGE: ?

Answer with LOCAL POSSIBLE DOSAGE:

ONE TEASPOONFUL O

You may enter a new LOCAL POSSIBLE DOSAGE, if you wish


Select LOCAL POSSIBLE DOSAGE: ONE TEASPOONFUL O

LOCAL POSSIBLE DOSAGE: ONE TEASPOONFUL// <ENTER>

OTHER LANGUAGE DOSAGE NAME: <ENTER>

PACKAGE: Outpatient// <ENTER>

DOSE UNIT: MILLIGRAM(S)// <ENTER>

NUMERIC DOSE:120//<ENTER>



Auto population of the NUMERIC DOSE sub-field (#5) of the LOCAL POSSIBLE

DOSAGES multiple (#904) in DRUG file (#50) and DOSE UNIT sub-field (#4) of the

LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) for Local Possible

Dosages of eligible drugs ONLY occurs during the post init of the PRE V.0.5 Pre-

Release patch installation. If you choose to delete your Local Possible Dosages when

remapping to NDF, then when redefining your Local Possible Dosages you will have to

repopulate the NUMERIC DOSE sub-field (#5) of the LOCAL POSSIBLE DOSAGES

multiple (#904) in DRUG file (#50) and DOSE UNIT sub-field (#4) of the LOCAL

POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) along with all other Local

Possible Dosage fields.

Note: Max days supply has been added to both the VA Product File (50.68) and the Drug

file (#50.0). This field allows the user to increase the Max Days supply allowed for a

drug to greater than 90 up to 365. Controlled substances will remain at 1-90 days supply.

MAXIMUM DAYS SUPPLY

<< Fields displayed when drug eligible for dosage check


User Manual

Maximum days supply has been added to both the VA PRODUCT file (#50.68) and the DRUG

file (#50). This field is used to determine the maximum number for days supply that may be

assigned to a drug. If this field is left blank, the MAXIMUM DAYS SUPPLY is set to a default

of 90 unless the drug is a controlled substance or Clozapine. Any value greater than 90 increases

the number of potential copay units above 3.

The maximum value allowed for this field is 365 (days) for most drugs, however:

• Schedule 2 controlled substances have a 30 day maximum days supply limit.

• Schedule 3-5 controlled substances have a 90 day maximum days supply limit.

• The maximum number of days supply for this drug cannot exceed the National Drug File

(NDF) maximum value if it exists in the VA PRODUCT file.

• No value can be entered for Clozapine drugs as the maximum days supply is controlled

by the Clozapine functionality.

The following chart shows the default values used when different values exist in the DRUG file

and VA PRODUCT file. Note the default quantity is determined by the patient’s PATIENT

STATUS field in the PRESCRIPTION file #52. In this example, the patient status allows for a

60 days supply.

DAYS

SUPPLY MAX DAYS SUPPLY

VA Product file (50.68)

MAX DAYS SUPPLY

Drug File (#50)

(Range for Days Supply): DEFAULT//

60 NULL NULL (1-90): 60//

60 NULL 365 (1-365): 60//

60 365 365 (1-365): 60//

60 300 265 (1-265): 60//

60 300 365 Cannot be greater than NDF Maximum Days Supply: 300

60 150 NULL (1-150): 60//

Example 2: Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option (showing a maximum days supply

of 365)

Select OPTION NAME: PSS DRUG ENTER/EDIT Drug Enter/Edit

Select DRUG GENERIC NAME: ASPIRIN BUFFERED 325MG TAB CN103 INTEN

...OK? Yes// (Yes)

*****************************************************************************


Outpatient

Unit Dose

Ward Stock

Non-VA Med

GENERIC NAME: ASPIRIN BUFFERED 325MG TAB Replace

VA CLASSIFICATION: CN103//

DEA, SPECIAL HDLG: 9P//

DAW CODE:


Copay Tier:

Copay Effective Date:


User Manual


VISN NON-FORMULARY:



Select SYNONYM: ASPIRIN 325MG CAP//

SYNONYM: ASPIRIN 325MG CAP//

INTENDED USE:

NDC CODE:

Select SYNONYM:

MESSAGE: INTEN//

RESTRICTION:

FSN:

NDC: 0182-0196-10//

INACTIVE DATE:

Pharmacy fill card display: DRUG WARNING 82N,10N,5N,307N,50N,73N,300N,94N




ORDER UNIT: EA//

PRICE PER ORDER UNIT: 4.25//

DISPENSE UNIT: CAP//


NCPDP DISPENSE UNIT: EACH//

NCPDP QUANTITY MULTIPLIER: 1//

MAXIMUM DAYS SUPPLY: 365

Example 3: Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option Marking of an Outpatient Drug for Clozapine or Lab Monitor

:

:


O - Outpatient

U - Unit Dose

I - IV

W - Ward Stock



X - Non-VA Med

A - ALL

Enter your choice(s) separated by commas : O

O - Outpatient

** You are NOW editing OUTPATIENT fields. **

AN Outpatient Pharmacy ITEM? Yes// <Enter> (Yes)

CORRESPONDING INPATIENT DRUG: CLOZAPINE 100MG TAB

// <Enter>

MAXIMUM DOSE PER DAY: <Enter>

LOCAL NON-FORMULARY: <Enter>

NORMAL AMOUNT TO ORDER: <Enter>

SOURCE OF SUPPLY: <Enter>

CURRENT INVENTORY: <Enter>

ACTION PROFILE MESSAGE (OP): RESTRICTED TO NATIONALLY REGISTERED PATIENTS.

Replace <Enter>

MESSAGE: NATL RESTRICTED (IEN) Replace <Enter>

QUANTITY DISPENSE MESSAGE: <Enter>

OP EXTERNAL DISPENSE: <Enter>

Do you wish to mark to transmit to CMOP?

Enter Yes or No: NO<Enter>

Do you wish to mark/unmark as a LAB MONITOR or CLOZAPINE DRUG?

Enter Yes or No: YES

Mark/Unmark for Lab Monitor or Clozapine:



User Manual

L LAB MONITOR

C CLOZAPINE

Enter response: CLOZAPINE

** You are NOW editing CLOZAPINE fields. **

Prescription of Clozapine requires identification of two

laboratory tests, WBC and Absolute Neutrophil Count (ANC).

You currently have both laboratory tests identified.

Type of

Test Lab Test Monitor Specimen Type

------- ---------------- -------------

1. WBC WBC SERUM

2. ANC ABSOLUTE NEUTROPHIL COUNT SERUM

(E)dit or (D)elete entry? <Enter>


CLOZAPINE (MYLAN) 100MG TAB is already matched to

CLOZAPINE (MYLAN) TAB


Example 4: Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option Editing Local Possible Dosages and

Orderable Item

Select DRUG GENERIC NAME: TIMOLOL MALEATE 0.5% OPH SOLN OP101

...OK? Yes// (Yes)

*******************************************************************************


Outpatient

Unit Dose

Non-VA Med

GENERIC NAME: TIMOLOL MALEATE 0.5% OPH SOLN Replace <Enter>

VA CLASSIFICATION: OP101// <Enter>

DEA, SPECIAL HDLG: 6P// <Enter>





DAW CODE: 0// <Enter>


Copay Tier: 2



VISN NON-FORMULARY: <Enter>

Select DRUG TEXT ENTRY: <Enter>

Select FORMULARY ALTERNATIVE: <Enter>

Select SYNONYM: 000006336710// <Enter>

SYNONYM: 000006336710// <Enter>

INTENDED USE: DRUG ACCOUNTABILITY// <Enter>

NDC CODE: 000006-3367-10// <Enter>

Select SYNONYM: <Enter>

MESSAGE: <Enter>

RESTRICTION: <Enter>

FSN: <Enter>

NDC: 6-3367-10// <Enter>

INACTIVE DATE: <Enter>


User Manual




WARNING LABEL: <Enter>

Current Warning labels for TIMOLOL MALEATE 0.5% OPH SOLN


22N For the eye.

290N If you are using other eye medications, wait at least 10 minutes before

applying them unless directed otherwise.

245N Date opened __________________




Would you like to edit this list of warnings? N// <Enter> O

ORDER UNIT: BT// <Enter>

PRICE PER ORDER UNIT: .89// <Enter>

DISPENSE UNIT: ML// <Enter>

DISPENSE UNITS PER ORDER UNIT: 5// <Enter>

NCPDP DISPENSE UNIT: EACH// <Enter>

NCPDP QUANTITY MULTIPLIER: 1// <Enter>



points to TIMOLOL MALEATE 0.5% SOLN,OPH in the National Drug file.




Do you wish to match/rematch to NATIONAL DRUG file? No// <Enter> (No)

Just a reminder...you are editing TIMOLOL MALEATE 0.5% OPH SOLN.


1 DROP PACKAGE: IO

2 DROPS PACKAGE: IO

Do you want to edit Local Possible Dosages? N// YES


1 DROP PACKAGE: IO

2 DROPS PACKAGE: IO


Strength: 0.5 Unit: %

Select LOCAL POSSIBLE DOSAGE: 1 DROP IO

LOCAL POSSIBLE DOSAGE: 1 DROP//<Enter>

OTHER LANGUAGE DOSAGE NAME: <Enter>

PACKAGE: Both// <Enter>

BCMA UNITS PER DOSE: <Enter>

DOSE UNIT: DROP(S)// <Enter>

NUMERIC DOSE: 1// <Enter>


Select LOCAL POSSIBLE DOSAGE: <Enter>

*******************************************************************************


Outpatient


User Manual

Unit Dose

Non-VA Med


O - Outpatient

U - Unit Dose

I - IV

W - Ward Stock



X - Non-VA Med

A - ALL


O - Outpatient


AN Outpatient Pharmacy ITEM? Yes// <Enter> (Yes)

CORRESPONDING INPATIENT DRUG: <Enter>

MAXIMUM DOSE PER DAY: <Enter>


NORMAL AMOUNT TO ORDER: <Enter>

SOURCE OF SUPPLY: 6P// <Enter>

CURRENT INVENTORY: <Enter>

ACTION PROFILE MESSAGE (OP): <Enter>

MESSAGE: <Enter>

QUANTITY DISPENSE MESSAGE: <Enter>

OP EXTERNAL DISPENSE: <Enter>



This option allows you to choose entries from your drug file and helps you

review your NDF matches and mark individual entries to send to CMOP.

If you mark the entry to transmit to CMOP, it will replace your Dispense Unit

with the VA Dispense Unit. In addition, you may overwrite the local drug name

with the VA Print Name and the entry will remain uneditable.

Local Drug Generic Name: TIMOLOL MALEATE 0.5% OPH SOLN

ORDER UNIT: BT

DISPENSE UNITS/ORDER UNITS: 5

DISPENSE UNIT: ML


VA Print Name: TIMOLOL MALEATE 0.5% OPH SOLN VA Dispense Unit: ML

VA Drug Class: OP101 CMOP ID: T0056

COPAY Tier: 2

Do you wish to mark this drug to transmit to CMOP?


QUANTITY DISPENSE MESSAGE: DISP IN MLS

Do you wish to overwrite your local name?

Enter Yes or No: NO

Do you wish to mark/unmark as a LAB MONITOR or CLOZAPINE DRUG?

Enter Yes or No: NO


TIMOLOL MALEATE 0.5% OPH SOLN is already matched to

TIMOLOL SOLN,OPH

Do you want to match to a different Orderable Item? NO// YES

Dosage Form -> SOLN,OPH


User Manual

Match to another Orderable Item with same Dosage Form? NO//

Dosage Form -> SOLN,OPH

Dispense Drug -> TIMOLOL 0.5% OPTH SOL 10ML

Orderable Item Name: TIMOLOL//

Matching TIMOLOL 0.5% OPTH SOL 10ML

to

TIMOLOL SOLN,OPH

Is this OK? YES//

Match Complete!

Now editing Orderable Item:

TIMOLOL SOLN,OPH

FORMULARY STATUS:

Select OI-DRUG TEXT ENTRY:

INACTIVE DATE:

DAY (nD) or DOSE (nL) LIMIT:

DEFAULT MED ROUTE:

List of med routes associated with the DOSAGE FORM of the orderable item:

RIGHT EYE

LEFT EYE

BOTH EYES

If you answer YES to the next prompt, the DEFAULT MED ROUTE (if populated)

and this list (if populated) will be displayed as selectable med routes

during medication ordering dialog. If you answer NO, the DEFAULT MED ROUTE

(if populated) and POSSIBLE MED ROUTES list will be displayed instead.

USE DOSAGE FORM MED ROUTE LIST: NO//

POSSIBLE MED ROUTES: BOTH

1 BOTH EARS AU

2 BOTH EYES BOTH EYES

CHOOSE 1-2: 2 BOTH EYES BOTH EYES

Are you adding 'BOTH EYES' as a new POSSIBLE MED ROUTE? YES// YES

List of Possible Med Routes associated with the orderable item:

BOTH EYES

POSSIBLE MED ROUTES:

SCHEDULE TYPE:

SCHEDULE:

HIGH RISK/HIGH ALERT

PROMPT FOR REMOVAL IN BCMA

PATIENT INSTRUCTIONS:

OTHER LANGUAGE INSTRUCTIONS:

MOST COMMON INDICATION FOR USE:

Select INDICATIONS FOR USE:

Select SYNONYM:

Example 5: Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option Editing Non-VA Medications

Select DRUG GENERIC NAME: GINGER ROOT TAB/CAP

Are you adding 'GINGER ROOT' as a new DRUG (the 1756TH)? No// Y (Yes)

DRUG NUMBER: 112// <Enter>

DRUG VA CLASSIFICATION: <Enter>

DRUG FSN: <Enter>


User Manual

DRUG NATIONAL DRUG CLASS: <Enter>

DRUG LOCAL NON-FORMULARY: N <Enter> N/F

DRUG INACTIVE DATE: <Enter>

DRUG MESSAGE: <Enter>

DRUG RESTRICTION: <Enter>

GENERIC NAME: GINGER ROOT TAB/CAP// ^DI

1 DISPENSE UNIT

2 DISPENSE UNITS PER ORDER UNIT

CHOOSE 1-2: 2 DISPENSE UNITS PER ORDER UNIT

DISPENSE UNITS PER ORDER UNIT: <Enter>


DAW CODE: 0// <Enter> - NO PRODUCT SELECTION INDICATED

Do you wish to match/rematch to NATIONAL DRUG file? Yes// (Yes)

Deleting Possible Dosages...

Match local drug GINGER ROOT

ORDER UNIT:


DISPENSE UNIT:

No NDC to match...

I will attempt to match the NDCs from your SYNONYMS.

No match by Synonym NDC... now first word

Match made with GINGER ROOT TAB/CAP

Now select VA Product Name

1 GINGER CAP/TAB CAP/TAB HA000 G0226

Enter your choice: 1

Is this a match < Reply Y, N or press return to continue > : Y

CHOOSE FROM:

1 60 BOTTLE

2 OTHER OTHER

Enter Package Size & Type Combination: 1

Local drug ginger root

matches GINGER CAP/TAB

PACKAGE SIZE: OTHER

PACKAGE TYPE: OTHER

< Enter "Y" for yes >

< Enter "N" for no > OK? : Y

LOCAL DRUG NAME: GINGER ROOT TAB/CAP

ORDER UNIT:

DISPENSE UNITS/ORDER UNITS:

DISPENSE UNIT:

VA PRODUCT NAME: GINGER CAP/TAB

VA PRINT NAME: GINGER CAP/TAB CMOP ID: G0226

VA DISPENSE UNIT: CAP/TAB MARKABLE FOR CMOP: NO

PACKAGE SIZE: BOTTLE

PACKAGE TYPE: OTHER

VA CLASS: HA000 HERBS/ALTERNATIVE THERAPIES

INGREDIENTS:

NATIONAL FORMULARY INDICATOR: NO

NATIONAL FORMULARY RESTRICTION:

< Enter "Y" for yes, "N" for no >

Is this a match ? Y

You have just VERIFIED this match and MERGED the entry.


User Manual



Just a reminder...you are editing GINGER ROOT TAB/CAP..


Do you want to edit Local Possible Dosages? N// <Enter> O


O - Outpatient

U - Unit Dose

I - IV

W - Ward Stock



X - Non-VA Med

A - ALL

Enter your choice(s) separated by commas : X

X - Non-VA Med

** You are NOW Marking/Unmarking for NON-VA MEDS. **

A Non-VA Med ITEM? No// Y (Yes)


There are other Dispense Drugs with the same VA Generic Name and same Dose

Form already matched to orderable items. Choose a number to match, or enter

'^' to enter a new one.

Disp. drug -> GINGER ROOT TAB/CAP

1 GINGER CAP/TAB

Choose number of Orderable Item to match, or '^' to enter a new one: 1

Matching GINGER ROOT TAB/CAP

to

GINGER CAP/TAB

Is this OK? YES// <Enter>

Match Complete!

Now editing Orderable Item: GINGER CAP/TAB

FORMULARY STATUS: <Enter>

Select OI-DRUG TEXT ENTRY: <Enter>


DAY (nD) or DOSE (nL) LIMIT: <Enter>

DEFAULT MED ROUTE: <Enter>


NO MED ROUTE DEFINED





USE DOSAGE FORM MED ROUTE LIST: YES// <Enter>


Example 6: Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option Editing Controlled Substances

Select DRUG GENERIC NAME: morphine sulf 15mg cr tab

MORPHINE SULF 15MG CR TAB CN101 WRITTEN RX REQUIRED

*******************************************************************************

Enter an up-arrow at the “FORMULARY STATUS” prompt to jump to the “Select

SYNONYM” prompt.


User Manual


Outpatient

Unit Dose

Controlled Substances

GENERIC NAME: MORPHINE SULF 15MG CR TAB Replace <Enter>

VA CLASSIFICATION: CN101// <Enter>

DEA, SPECIAL HDLG: 2C// <Enter>

The CS Federal Schedule associated with this drug in the VA Product File represents a DEA,

Special Handling code of 2A.

DEA, SPECIAL HDLG: 2C// 2A


Example 7: Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option Dispense As Written (DAW) Code Editing

Select OPTION NAME: PSS DRUG

1 PSS DRUG ENTER/EDIT Drug Enter/Edit

2 PSS DRUG TEXT FILE REPORT Drug Text File Report

CHOOSE 1-2: 1 PSS DRUG ENTER/EDIT Drug Enter/Edit

Drug Enter/Edit

Select DRUG GENERIC NAME: METAPROTERENOL 5% SOLUTION 10ML RE102

...OK? Yes// <Enter> (Yes)

*******************************************************************************


Outpatient

Unit Dose

Non-VA Med

GENERIC NAME: METAPROTERENOL 5% SOLUTION 10ML Replace

VA CLASSIFICATION: RE102// <Enter>

DEA, SPECIAL HDLG: <Enter>

DAW CODE: 0// ?

Dispensed As Written code. This information is used for NCPDP electronic

claim transmission to third party payers (insurance companies).

Answer with BPS NCPDP DAW CODE

Choose from:

0 NO PRODUCT SELECTION INDICATED

1 SUBSTITUTION NOT ALLOWED BY PRESCRIBER

2 SUBSTITUTION ALLOWED-PATIENT REQUESTED PRODUCT DISPENSED

3 SUBSTITUTION ALLOWED-PHARMACIST SELECTED PRODUCT DISPENSED

4 SUBSTITUTION ALLOWED-GENERIC DRUG NOT IN STOCK

5 SUBSTITUTION ALLOWED-BRAND DRUG DISPENSED AS A GENERIC

6 OVERRIDE

7 SUBSTITUTION NOT ALLOWED-BRAND DRUG MANDATED BY LAW

8 SUBSTITUTION ALLOWED-GENERIC DRUG NOT AVAILABLE IN MARKETPLACE

9 OTHER





DAW CODE: 0// <Enter> - NO PRODUCT SELECTION INDICATED


Copay Tier: 2



VISN NON-FORMULARY: <Enter>

Select DRUG TEXT ENTRY: <Enter>

Select FORMULARY ALTERNATIVE: <Enter>

Select SYNONYM: METAPROTERENOL SULFATE 5% INHL SOLN

// <Enter>

SYNONYM: METAPROTERENOL SULFATE 5% INHL SOLN Replace

INTENDED USE: <Enter>

NDC CODE: <Enter>


MESSAGE: <Enter>

RESTRICTION: <Enter>


User Manual

FSN: <Enter>

NDC: 49502-0676-03// <Enter>





WARNING LABEL:

Current Warning labels for METAPROTERENOL SULFATE 0.6% INHL SOLN


13N It is very important that you take or use this exactly as directed. Do

not skip doses or discontinue unless directed by your doctor.

109N WARNING: DO NOT exceed the dose prescribed by your physician. If

difficulty in breathing persists, contact your physician.

14N Obtain medical advice before taking non-prescription drugs as some may

affect the action of this medication.





ORDER UNIT: PG//

PRICE PER ORDER UNIT: 6.16//

DISPENSE UNIT: 2.5ML//


NCPDP DISPENSE UNIT: MILLILITERS//

NCPDP QUANTITY MULTIPLIER: 2.5//



points to METAPROTERENOL SO4 0.6% SOLN,INHL in the National Drug file.




This drug has also been marked to transmit to CMOP.

If you choose to rematch it, the drug will be marked NOT TO TRANSMIT to CMOP.


Just a reminder...you are editing METAPROTERENOL SULFATE 0.6% INHL SOLN.


1 AMPULE PACKAGE: IO

2 AMPULES PACKAGE: IO

Do you want to edit Local Possible Dosages? N// O

*******************************************************************************


Outpatient

Unit Dose

Non-VA Med


O - Outpatient

U - Unit Dose

I - IV

W - Ward Stock



X - Non-VA Med

A - ALL

Enter your choice(s) separated by commas :



User Manual

METAPROTERENOL SULFATE 0.6% INHL SOLN is already matched to

METAPROTERENOL SULFATE 0.6% (2.5ML) SOLN,INHL


With Patch PSS*1*92, the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option is modified to

allow the user to enter a Service Code in the DRUG file (#50).

Note: Service Codes are assigned by the Charge Description Master Change Control

Board. No entry should be made without coordination of the Change Control Board to

assign the code.

If a drug is matched to an entry in the VA PRODUCT file (#50.68) of the NDF package, a

Service Code need not be entered in the DRUG file (#50). If a Service Code is defined for drugs

of this type in the DRUG file (#50) and is matched in the VA PRODUCT file (#50.68), the value

defined in the VA PRODUCT file (#50.68) takes precedence.

The PSSCOMMON input template portion of the Drug Enter/Edit [PSS DRUG ENTER/EDIT]

option is modified to allow entry of the new SERVICE CODE field (#400).

The following is an incomplete example showing only the display when the drug is matched to

NDF so there is no prompt for a Service Code.

Example 8: Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option Drug matched to NDF, no prompt for

Service Code

NDC:

INACTIVE DATE:

<-----→ Note: here between inactive date and warning label is where the Service Code prompt

would have been displayed if the drug had not been matched to NDF.

WARNING LABEL SOURCE is not 'NEW'.

WARNING LABEL will be used until the WARNING LABEL SOURCE is set to 'NEW'.

The following is an incomplete example showing only the display when the drug is not matched

to NDF so a Service Code is entered.

Example 9: Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option Drug not matched to NDF, entering a

Service Code

NDC:

INACTIVE DATE:

If you are planning to match to a NDF entry later or have no plan of using

the external billing function, you may skip the Service Code entry.

SERVICE CODE: ?

This is required for external billing purposes only. Answer must be

between 600001-699999.

SERVICE CODE: ??

The Charge Description Master (CDM) Change Control board assigns value

for this field. The value should be a number between 600001-699999.

SERVICE CODE: 699991


User Manual

Patch PSS*1*147 enhances the Drug Enter/Edit [PSS DRUG ENTER/EDIT] option to display

the NUMERIC DOSE sub-field (#5) of the LOCAL POSSIBLE DOSAGES multiple (#904) in

DRUG file (#50) and DOSE UNIT sub-field (#4) of the LOCAL POSSIBLE DOSAGES

multiple (#904) in DRUG file (#50) defined for Local Possible Dosages and allows editing of the

new Additive Frequency field (#18) in the IV ADDITIVES file (#52.6).

Example 1: Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option Rematching of drug to NDF

Select Pharmacy Data Management Option: Drug Enter/Edit

Select DRUG GENERIC NAME: TIMOPTIC

Lookup: SYNONYM

1 TIMOPTIC 0.25% TIMOLOL 0.25% OPTH SOL 10ML OP101

2 TIMOPTIC 0.5% TIMOLOL 0.5% OPTH SOL 10ML OP101

CHOOSE 1-2: 2 TIMOLOL 0.5% OPTH SOL 10ML OP101

*****************************************************************************


Outpatient

Unit Dose

Non-VA Med

GENERIC NAME: TIMOLOL 0.5% OPTH SOL 10ML Replace <ENTER>

VA CLASSIFICATION: OP101// <ENTER>

DEA, SPECIAL HDLG: 6P// <ENTER>





DAW CODE: <ENTER>

.

.

.


points to TIMOLOL MALEATE 0.5% SOLN,OPH in the National Drug file.




Do you wish to match/rematch to NATIONAL DRUG file? No// Y <ENTER> (Yes)



1 DROP (Package -> O)

2 DROP(S) (Package -> O)

Delete these Local Possible Dosages? Y// NO

Local Possible Dosages not deleted.

Match local drug TIMOLOL 0.5% OPTH SOL 10ML

ORDER UNIT: BT


DISPENSE UNIT:

I will try to match NDC: 6-3367-10 to NDF.

Local drug TIMOLOL 0.5% OPTH SOL 10ML

matches TIMOLOL MALEATE 0.5% SOLN,OPH

PACKAGE SIZE: 10 ML

PACKAGE TYPE: BOTTLE


User Manual

Is this a match ?

Enter Yes or No: YES// <ENTER>

LOCAL DRUG NAME: TIMOLOL 0.5% OPTH SOL 10ML

ORDER UNIT: BT


DISPENSE UNIT:

VA PRODUCT NAME: TIMOLOL MALEATE 0.5% SOLN,OPH

VA PRINT NAME: TIMOLOL MALEATE 0.5% OPH SOLN CMOP ID: T0056

VA DISPENSE UNIT: ML MARKABLE FOR CMOP: YES

PACKAGE SIZE: 10 ML


VA CLASS: OP101 BETA-BLOCKERS,TOPICAL OPHTHALMIC

CS FEDERAL SCHEDULE:

INGREDIENTS:

TIMOLOL MALEATE 0.5 %



Copay Tier: 2



Is this a match ? Y



Press Return to continue: <ENTER>


1 DROP PACKAGE: IO


NUMERIC DOSE: DOSE UNIT:

2 DROP(S) PACKAGE: IO




Just a reminder...you are editing TIMOLOL 0.5% OPTH SOL 10ML.


1 DROP PACKAGE: IO






Do you want to edit Local Possible Dosages? N// YES


1 DROP PACKAGE: IO








User Manual

Example 2: Editing Additive Frequency for IV Additive

Select Pharmacy Data Management Option: Drug Enter/Edit

Select DRUG GENERIC NAME: CIMETIDINE 150MG/ML MDV INJ (8ML) GA301

...OK? Yes// <ENTER> (Yes)

***************************************************************************


IV

Ward Stock

GENERIC NAME: CIMETIDINE 150MG/ML MDV INJ (8ML) Replace <ENTER>

VA CLASSIFICATION: GA301// <ENTER>

DEA, SPECIAL HDLG: <ENTER>





DAW CODE: <ENTER>

.

.

.

***************************************************************************


IV

Ward Stock


O - Outpatient

U - Unit Dose

I - IV

W - Ward Stock



X - Non-VA Med

A - ALL

Enter your choice(s) separated by commas : I

I - IV

** You are NOW editing IV fields. **

AN IV ITEM? Yes// <ENTER> (Yes)



A ADDITIVES

S SOLUTIONS

Enter response: ADDITIVES

Select IV SOLUTIONS PRINT NAME: CIMETIDINE// <ENTER>

PRINT NAME: CIMETIDINE// <ENTER>

Select DRUG GENERIC NAME: CIMETIDINE 150MG/ML MDV INJ (8ML)// <ENTER>

ARE YOU SURE YOU WANT TO SELECT CIMETIDINE 150MG/ML MDV INJ (8ML) ? No// Y (Yes)

USED IN IV FLUID ORDER ENTRY: YES// <ENTER>

DRUG UNIT: MG// <ENTER>

NUMBER OF DAYS FOR IV ORDER: <ENTER>

USUAL IV SCHEDULE: <ENTER>

ADMINISTRATION TIMES: <ENTER>

Select QUICK CODE: <ENTER>

AVERAGE DRUG COST PER UNIT: <ENTER>

Select ELECTROLYTE: <ENTER>

Select SYNONYM: <ENTER>

DRUG INFORMATION: <ENTER>

1>

INACTIVATION DATE: <ENTER>

CONCENTRATION: <ENTER>


User Manual

MESSAGE: <ENTER>

ADDITIVE FREQUENCY: ALL BAGS// <ENTER>

Edit Additives or Solutions: <ENTER>


A ADDITIVES

S SOLUTIONS

Enter response:

Patch PSS*1*155 addresses supra-therapeutic and sub-therapeutic dosages. A supra-therapeutic

dosage is one that far exceeds the normal therapeutic range. A sub-therapeutic dosage is one that

is far below the normal therapeutic range. Certain drugs with an automatically calculated dosage

of one time or two times the base strength that is supra- or sub-therapeutic will be adjusted to not

auto-create those default possible dosages. Such changes will be distributed during the Monthly

NDF Updates. PSS*1*155 uses the three new fields added to the VA PRODUCT file (#50.68)

by PSN*4*261 to prevent the inadvertent creation of supra-therapeutic possible dosages for high

risk medications during the dosage creation segment of Pharmacy Data Management and

National Drug File updates. These fields will be used during the Match/Rematch process of the

Drug Enter/Edit [PSS DRUG ENTER/EDIT] option to determine if possible dosages should be

auto-created or not. The three fields are:

• CREATE DEFAULT POSSIBLE DOSAGE field (#40)

• POSSIBLE DOSAGES TO CREATE field (#41)

• PACKAGE field (#42)

When CREATE DEFAULT POSSIBLE DOSAGE field (#40) is “YES”, then the existing

functionality of auto-creating possible dosages will be retained. When this field is “NO”, it will

be used in combination with the value in POSSIBLE DOSAGES TO CREATE field (#41) to

determine the auto-creation of possible dosages. Example 1: Supra-Therapeutic Drugs – Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option – Message displayed when Create Default Possible Dosage is Yes and no possible dosages auto-created

Do you wish to match/rematch to NATIONAL DRUG file? No// YES (Yes)


Match local drug INSULIN NPH U-100 INJ

ORDER UNIT: VI


DISPENSE UNIT:


I will attempt to match the NDCs from your SYNONYMS.

ORDER UNIT: VI

Match made with INSULIN NPH U-100 INJ

Now select VA Product Name

18 INSULIN NPH HUMAN 100 U/ML INJ HUMULIN N INJ HS501 I0160

19 INSULIN NPH HUMAN 100 U/ML INJ INNOLET 3ML INJ HS501 I0356

20 INSULIN NPH HUMAN 100 U/ML INJ NOVOLIN N INJ HS501 I0161

Enter your choice or press return to continue: 18

Is this a match < Reply Y, N or press return to continue > : y

CHOOSE FROM:

1 10 ML VIAL

2 OTHER OTHER

Enter Package Size & Type Combination: 1

Local drug INSULIN NPH U-100 INJ

matches INSULIN NPH HUMAN 100 U/ML INJ HUMULIN N


User Manual

PACKAGE SIZE: 10 ML

PACKAGE TYPE: VIAL

< Enter "Y" for yes >

< Enter "N" for no > OK? : Y

LOCAL DRUG NAME: INSULIN NPH U-100 INJ

ORDER UNIT: VI


DISPENSE UNIT:

VA PRODUCT NAME: INSULIN NPH HUMAN 100 U/ML INJ HUMULIN N

VA PRINT NAME: INSULIN NPH HUMAN 100 UNIT/ML HUMULIN N CMOP ID: I0160

VA DISPENSE UNIT: VI MARKABLE FOR CMOP: YES

PACKAGE SIZE: 10 ML

PACKAGE TYPE: VIAL

VA CLASS: HS501 INSULIN


INGREDIENTS:

INSULIN,NPH,HUMAN/rDNA 100 UNT/ML



Copay Tier: 2



Is this a match ? Y




Just a reminder...you are editing INSULIN NPH U-100 INJ.

Strength from National Drug File match => 100 UNT/ML



Press Return to continue,'^' to exit:

POSSIBLE DOSAGES:


Due to National Drug File settings no possible dosages were auto-created.

Do you want to manually enter possible dosages? N// YES


STRENGTH: 100//




Select DISPENSE UNITS PER DOSE: 1

Are you adding '1' as a new POSSIBLE DOSAGES (the 1ST for this DRUG)? No// Y

(Yes)

Dosage = 100

POSSIBLE DOSAGES DOSE: 100// (No Editing)

The prompt “Do you want to manually enter possible dosages? N//” is displayed only when no possible dosages were auto-created.


User Manual

DISPENSE UNITS PER DOSE: 1// 0.1

PACKAGE: IO


Select DISPENSE UNITS PER DOSE

Example 2: Supra-Therapeutic Drugs – Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option – Message displayed when Create Default Possible Dosage is Yes and 1 possible dosage auto-created

Do you wish to match/rematch to NATIONAL DRUG file? No// YES (Yes)


Match local drug LOMUSTINE 100MG CAP

ORDER UNIT: BT


DISPENSE UNIT:


Local drug LOMUSTINE 100MG CAP

matches LOMUSTINE 100MG CAP

PACKAGE SIZE: 20


Is this a match ?

Enter Yes or No: YES// YES

LOCAL DRUG NAME: LOMUSTINE 100MG CAP

ORDER UNIT: BT


DISPENSE UNIT:

VA PRODUCT NAME: LOMUSTINE 100MG CAP

VA PRINT NAME: LOMUSTINE 100MG CAP CMOP ID: L0055

VA DISPENSE UNIT: CAP MARKABLE FOR CMOP: YES

PACKAGE SIZE: 20


VA CLASS: AN100 ANTINEOPLASTICS,ALKYLATING AGENTS


INGREDIENTS:

LOMUSTINE 100 MG



Copay Tier: 2



Is this a match ? Y




Just a reminder...you are editing LOMUSTINE 100MG CAP.





POSSIBLE DOSAGES:

DISPENSE UNITS PER DOSE: 1 DOSE: 100MG PACKAGE: IO


User Manual


Due to National Drug File settings only ONE possible dosage was auto-created. If other

dosages are needed, create POSSIBLE DOSAGES or LOCAL POSSIBLE DOSAGES as appropriate.



STRENGTH: 100//



Choose from:

1 100 IO




Example 3: Supra-Therapeutic Drugs – Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option – Message displayed when Create Default Possible Dosage is Yes and 2 possible dosages auto-created

Do you wish to match/rematch to NATIONAL DRUG file? No// Y (Yes)


Match local drug DACARBAZINE 200MG INJ

ORDER UNIT: BX


DISPENSE UNIT:


Local drug DACARBAZINE 200MG INJ

matches DACARBAZINE 200MG/VIL INJ

PACKAGE SIZE: 12 X 200 MG

PACKAGE TYPE: VIAL

Is this a match ?

Enter Yes or No: YES// YES

LOCAL DRUG NAME: DACARBAZINE 200MG INJ

ORDER UNIT: BX


DISPENSE UNIT:

VA PRODUCT NAME: DACARBAZINE 200MG/VIL INJ MARKABLE FOR CMOP: NOT

MARKED

PACKAGE SIZE: 12 X 200 MG

PACKAGE TYPE: VIAL

VA CLASS: AN900 ANTINEOPLASTIC,OTHER


INGREDIENTS:

DACARBAZINE 200



Copay Tier: 2



Is this a match ? Y




User Manual


Just a reminder...you are editing DACARBAZINE 200MG INJ.

Strength from National Drug File match => 200 MG/VIAL




POSSIBLE DOSAGES:

DISPENSE UNITS PER DOSE: 1 DOSE: 200MG/1VIAL PACKAGE: IO

DISPENSE UNITS PER DOSE: 2 DOSE: 400MG/2VIAL PACKAGE: IO



Do you want to edit the dosages? N//

The following conditions will apply when CREATE DEFAULT POSSIBLE DOSAGE field

(#40) is “NO”:

• If POSIBLE DOSAGES TO CREATE field (#41) is “NO”, no possible dosages will be

auto-created and the following message will be displayed:

“This drug has been set within the National Drug File to not auto create possible

dosages.”

• If POSSIBLE DOSAGES TO CREATE field (#41) is "O", 1x possible dosage will be

auto-created for the package specified by the new PACKAGE field (#42) and the


“This drug has been set within the National Drug File to auto create only one possible

dosage.”

• If POSSIBLE DOSAGES TO CREATE field (#41) is “B”, 1x and 2x possible dosages

will be auto-created for the package specified by the new PACKAGE field (#42) and the


“This drug has been set within the National Drug File to auto create two possible dosages

Example 4: Supra-Therapeutic Drugs – Drug Enter/Edit [PSS DRUG ENTER/EDIT] Option -- Message

displayed when NDF is set to not auto-create Possible Dosages


Just a reminder...you are editing LOMUSTINE 10MG CAP




POSSIBLE DOSAGES:


This drug has been set within the National Drug File to not auto create possible dosages.

Do you want to manually enter possible dosages? N//


User Manual


displayed when NDF is set to auto-create 1 Possible Dosage




This drug has been set within the National Drug File to auto create only one

possible dosage.



Due to National Drug File settings only ONE possible dosage was auto-created. If other

dosages are needed, create POSSIBLE DOSAGES or LOCAL POSSIBLE DOSAGES as appropriate.





POSSIBLE DOSAGES:

DISPENSE UNITS PER DOSE: 1 DOSE: 10 MG PACKAGE: IO


This drug has been set within the National Drug File to auto create only one possible dosage.



displayed when NDF is set to auto-create 2 Possible Dosages




This drug has been set within the National Drug File to auto create two

possible dosages.








POSSIBLE DOSAGES:




This drug has been set within the National Drug File to auto create two possible dosages.



User Manual

Multiple Automated Dispensing Devices (ADD)

Patch PSS*1*156, in conjunction will PSO*7*354, allows sites to send prescriptions to multiple

ADDs. Defining a dispensing device at the drug level for a division will override the dispensing

device settings in the OUTPATIENT SITE file (#59). If populated, the drug will be sent to the

dispensing device for that division. There are two types of ADDs, window and mail, and these

are based on the route of the prescription. The prompt “OP EXTERNAL DISPENSE:” must be

YES for an ADD to be added to a drug. The following example illustrates the set-up for the drug

CIMETIDINE 200MG TAB to be sent to the dispensing device SCRIPTPRO1 for window

prescriptions and SCRIPTPRO2 for mail prescriptions.

Example 1: Assigning Dispensing Device for a Drug

Select OPTION NAME: PSS DRUG ENTER/EDIT Drug Enter/Edit

Select DRUG GENERIC NAME: CIMETIDINE 200MG TAB GA301

...OK? Yes// (Yes)

*******************************************************************************


Outpatient

Unit Dose

Non-VA Med

GENERIC NAME: CIMETIDINE 200MG TAB Replace

VA CLASSIFICATION: GA301//

DEA, SPECIAL HDLG: 6P//

*******************************************************************************


Outpatient

Unit Dose

Non-VA Med


O - Outpatient

U - Unit Dose

I - IV



X - Non-VA Med


O - Outpatient


AN Outpatient Pharmacy ITEM? Yes// (Yes)

.

.

QUANTITY DISPENSE MESSAGE:

OP EXTERNAL DISPENSE: YES//

Defining a dispensing device at the drug level for a division will override

the dispensing device settings in the OUTPATIENT SITE File (#59). If populated,

the drug will be sent to the dispensing device for that division.

Select DIVISION: ALBANY //

DIVISION: ALBANY //

WINDOW DNS NAME: SCRIPTPRO1//

MAIL DNS NAME: SCRIPTPRO2//

Select DIVISION:


User Manual

The following actions will apply when OP EXTERNAL DISPENSE field (#28) is YES:

• To change where a drug is being routed, simply change the ADD associated with the

drug.

Select DIVISION: ALBANY//

DIVISION: ALBANY//

WINDOW DNS NAME: SCRIPTPRO1// scriptpro3 [email protected] 9002

MAIL DNS NAME: SCRIPTPRO2//

Select DIVISION:

ADDs can be removed from an ADD defined in the DRUG file (#50) for specific drugs for a site.

Select DIVISION: troy 514

...OK? Yes// (Yes)

DIVISION: TROY// @

SURE YOU WANT TO DELETE THE ENTIRE DIVISION? y (Yes)

Select DIVISION:

• If the response to OP EXTERNAL DISPENSE field (#28) is NO, then there will be no

prompt to add an ADD.

OP EXTERNAL DISPENSE: N NO


Enter Yes or No:

Patch PSS*1*146 addresses a functionality change to prevent erroneous matching with

Dispense Drugs. It is very easy to select the wrong item and incorrectly change the PRINT

NAME field (#.01) of the IV ADDITIVES file (#52.6) and/or IV SOLUTIONS file (#52.7).

Also, once an additive or solution is selected, it is unclear as to whether or not the user is still

selecting or editing.

Patch PSS*1*146 enhances this process by displaying the previously entered Print Name as the

default if only one is entered.

Example:

Select IV ADDITIVES PRINT NAME: ADDITIVE1//

If more than one Print Name were previously entered, the software will display the list of all

linked Additives and/or Solutions to select from so an edit may be made. Example:

<DRUG NAME> currently linked to the following IV

Additives:

1. ADDITIVE1

2. ADDITIVE2

Select 1-2 from list above or type 'NEW' to link

to a new IV Additive:

The Patch PSS*1*146 enhancement also allows the user to enter a new Additive or Solution and

link it to the dispense drug. The software will give the user the choice to enter and link the

dispense drug to a new Additive or Solution as well as require a confirmation of the selected

dispense drug that will be linked to the selected Additive/Solution.


User Manual

Example (Create new IV Additive and link to drug):

<DRUG NAME> currently linked to the following IV Additives:

1. ADDITIVE1

2. ADDITIVE2


to a new IV Additive: NEW

Select IV ADDITIVES PRINT NAME: TEST

Are you adding 'TEST' as a new IV ADDITIVES (the 33RD)? No// Yes

IV ADDITIVES DRUG UNIT: GM GM

PRINT NAME: TEST//

Select DRUG GENERIC NAME: CEFAMANDOLE 1GM INJ// AM116

ARE YOU SURE YOU WANT TO SELECT CEFAMANDOLE 1GM INJ? No// Y (Yes)

...

<DRUG NAME> currently linked to the following IV Additives:

1. ADDITIVE1

2. ADDITIVE2

3. TEST


to a new IV Additive: NEW

The patch PSS*1*172 enhancement allows the user to mark orderable items for designation as

High Risk/High Alert medications which will then trigger an alert in BCMA at the time of

administration for a witness signature. For administrations where the orderable item has a High

Risk/High Alert drug code of 2 (witness recommended) or 3 (witness required), if the witness

credentials are authenticated, administration is marked as Given or Infusing, and the user is

returned to the BCMA VDL. If the witness credentials are completed, but not authenticated,

administration will not continue until the user enters valid access and verify codes and has the

authority to be a witness.

For administrations where the orderable item has a High Risk/High Alert drug code value of 2

(witness recommended), the user can bypass the witness sign-on when no witness is available, by

acknowledging that the High Risk/High Alert medication is being administered without the

presence of an authorized witness.

For BCMA to prompt for a witness during High Risk/High Alert medication administration, the

orderable item for the medication is flagged in the HIGH RISK/HIGH ALERT DRUG field (#1)

in the local PHARMACY ORDERABLE ITEM file (#50.7).

Upon installation, the HIGH RISK/HIGH ALERT DRUG field (#1) will be set to null or 0 (not a

high risk/high alert drug).

The HIGH RISK/HIGH ALERT DRUG field (#1) provides the following four qualifying codes:

a. 0/Null = Not a high risk/high alert drug

b. 1 = High risk/high alert – does NOT recommend or require a witness in BCMA (this

category was created for documentation purposes only, e.g., running reports).

c. 2 = High risk/high alert – recommended to witness in BCMA


User Manual

d. 3 = High risk/high alert – required to witness in BCMA

To set the HIGH RISK/HIGH ALERT DRUG field (#1) values in the local PHARMACY

ORDERABLE ITEM file (#50.7), complete the steps shown in the example below.

Example (Modify Pharmacy Orderable Item File):

Select OPTION NAME: PSS EDIT ORDERABLE ITEMS Edit Orderable Items


This option enables you to edit Orderable Item names, Formulary status,

drug text, Inactive Dates, and Synonyms.

Select PHARMACY ORDERABLE ITEM NAME: HEPARIN

1 HEPARIN INJ,SOLN

2 HEPARIN SOLN

CHOOSE 1-2: 1 HEPARIN INJ,SOLN

Orderable Item -> HEPARIN

Dosage Form -> INJ,SOLN

List all Drugs/Additives/Solutions tied to this Orderable Item? YES//

Orderable Item -> HEPARIN

Dosage Form -> INJ,SOLN

Dispense Drugs:

---------------

HEPARIN BEEF 1,000 UNITS/ML 30ML

HEPARIN 1,000 UNIT/ML 10ML INJ

HEPARIN 10,000 UNITS 4ML

HEPARIN 1,000 UNITS/ML 30ML

HEPARIN, BEEF 10,000 UNIT/ML 4ML

HEPARIN, BEEF 1,000 UNIT/ML 10ML

Are you sure you want to edit this Orderable Item? NO// YES


HEPARIN INJ,SOLN

Orderable Item Name: HEPARIN//

This Orderable Item is Formulary.

This Orderable Item is marked as a Non-VA Med.


INACTIVE DATE:


DEFAULT MED ROUTE: INTRAVENOUS//


INTRAMUSCULAR

INTRAVENOUS





USE DOSAGE FORM MED ROUTE LIST: YES//

SCHEDULE TYPE:

SCHEDULE:

HIGH RISK/HIGH ALERT: ?

Choose from:

0 NOT HIGH RISK/ALERT


User Manual

1 HIGH RISK/ALERT – NO WITNESS REQUIRED IN BCMA

2 RECOMMEND WITNESS IN BCMA – HIGH RISK/ALERT

3 WITNESS REQUIRED IN BCMA – HIGH RISK/ALERT

HIGH RISK/HIGH ALERT: 3 WITNESS REQUIRED-BCMA HIGH RISK/ALERT

Note: When responding to the prompt above, VistA accepts a 0, 1, 2, or 3 or will allow

the user to type the first letter of the description, i.e., N, H, R, or W.

The patch PSS*1*191 enhancement allows users to designate transdermal patches and other

orderable items that warrant removal, e.g., nitroglycerin paste, which will trigger an Alert in

BCMA for removal. A PROMPT FOR REMOVAL IN BCMA Field (#12) has been added to

the local Pharmacy Orderable Item File (#50.7). Refer to section 1.9.1 for additional information.

To set the values for PROMPT FOR REMOVAL IN BCMA (Field #12) in the local

PHARMACY ORDERABLE ITEM File (#50.7) (i.e., using PSS EDIT ORDERABLE ITEMS),

complete the steps shown in the example below:

The PROMPT FOR REMOVAL IN BCMA Field (#12) provides the following qualifying codes:

Choose from:

0 No Removal Required

1 Removal at Next Administration

2 Removal Period Optional Prior to Next Administration

3 Removal Period Required Prior to Next Administration

• NULL/0 = No Removal Required. Duration of Administration field does not display

when the Pharmacist is finishing the order. This is consistent with existing functionality

for tablets, capsules and other unit dose medications not requiring removal.

• 1 = Removal at Next Administration. Duration of Administration field does not display

when the Pharmacist is finishing the order. BCMA user will be prompted for removal

automatically at next administration.

• 2 = Removal Period Optional Prior to Next Administration. The Pharmacist is prompted

for Duration of Administration when finishing the order; however, this field is

optional/not required to finish the order. If Duration of Administration is entered by the

Pharmacist finishing the order, the BCMA user will be prompted for removal when the

Duration of Administration has ended. If no Duration of Administration is entered,

BCMA user will be prompted for removal at next administration.

• 3 = Removal Period Required Prior to Next Administration. The Pharmacist is prompted

for Duration of Administration, which is required to finish the order. BCMA user will be

prompted for removal after the Duration of Administration has ended.

Example: Prompt for Removal in BCMA


User Manual

SCHEDULE TYPE: CONTINUOUS//

SCHEDULE: Q24H//

HIGH RISK/HIGH ALERT: WITNESS REQUIRED IN BCMA-HIGH RISK/ALERT //

PROMPT FOR REMOVAL IN BCMA: Removal Period Required Prior to Next Administration // ?

ENTRY OF 1, 2 OR 3 IS REQUIRED FOR DOSAGE FORM PATCH.

Enter the value that applies to this orderable item.

Choose from:




PROMPT FOR REMOVAL IN BCMA: Removal Period Required Prior to Next Administration

// ??


User Manual

Send a Drug Update to PADE (Pharmacy Automated Dispensing Equipment)

A new prompt is available from the [PSS Drug Enter/Edit] menu which allows the user to send a

drug update to PADE.

You can access the new prompt via the following menu path:

PSS MGR Pharmacy Data Management > Drug Enter/Edit [PSS DRUG ENTER/EDIT]

The new prompt is displayed when the drug being edited is marked for Unit Dose and/or IV use

and at least one active PADE system exists. Select OPTION NAME: PSS DRUG ENTER/EDIT Drug Enter/Edit

Drug Enter/Edit

Select DRUG GENERIC NAME: ATENOLOL 25MG TAB CV100

...OK? Yes// (Yes)

*******************************************************************************


Outpatient

Unit Dose

Ward Stock

Non-VA Med

GENERIC NAME: ATENOLOL 25MG TAB//

VA CLASSIFICATION: CV100//


DAW CODE: ^

This drug is marked for either UD or IV use, and you have at least

one active Pharmacy Automated Dispensing Equipment (PADE).

Would you like to send a drug file update to PADE?

Copay Tiers

Patch PSS*1*200 added the display only of COPAY TIER information after the VISN NON-

FORMULARY display. It will display COPAY TIER LEVEL field (#.01) and COPAY

EFFECTIVE DATE (#2) of the COPAY TIER multiple (#45) in the VA PRODUCT FILE

(#50.68).

Example #1: Display only of copay tier information

Select DRUG GENERIC NAME: WARFAR


1 WARFARIN 2MG TABS BL110 Tier 3 THIS IS A MESSAGE FOR TESTING THE ME

SSAGE IDENTIFIER

2 WARFARIN 4MG TAB BL110

3 WARFARIN NA (EXELAN) 10MG TAB BL110 Tier 2

4 WARFARIN NA 5MG/VIL INJ

5 WARFARIN SOD. 50MG COMB.PACK. BL110

Press <RETURN> to see more, '^' to exit this list, '^^' to exit all lists, OR

CHOOSE 1-5: 3 WARFARIN NA (EXELAN) 10MG TAB BL110 Tier 2


User Manual

*******************************************************************************


Outpatient

GENERIC NAME: WARFARIN NA (EXELAN) 10MG TAB Replace

VA CLASSIFICATION: BL110//

DEA, SPECIAL HDLG:

DAW CODE:


Copay Tier: 2



VISN NON-FORMULARY:



Select SYNONYM: WARFARIN NA (EXELAN) 10MG TAB//

SYNONYM: WARFARIN NA (EXELAN) 10MG TAB Replace

INTENDED USE:

NDC CODE:

Select SYNONYM:

MESSAGE:

RESTRICTION:

FSN:

NDC:

INACTIVE DATE:

1.3.1 Drug File Audits This section describes audit notifications and history for changes made to the DRUG file (#50). These features were enabled by patch PSS*1*227.

1.3.1.1 Drug File Audit Notification

Patch PSS*1*227 generates a message to a new mail group called PSS DEE AUDIT when a user modifies certain fields in the DRUG file (#50) through the Drug Enter/Edit [PSS DRUG ENTER/EDIT] menu option. The message shows the date/time of the change, the name of the user who made the change, and before/after descriptions of the changed field(s). In addition, the Pharmacy Price Tracker function sends a separate audit message to the PSS DEE AUDIT mail group when the PRICE PER DISPENSE UNIT field (#16) is added or changed, or when the PRICE PER DISPENSE UNIT field is automatically updated by a change to the PRICE PER ORDER UNIT field (#13). The Pharmacy Price Tracker message shows the new field value for the drug, and identifies the user or process associated with the change. These audit features allow Pharmacy personnel to maintain consistency and control when multiple users create and edit DRUG file entries across integrated facilities. Sample messages for Drug Enter/Edit and Pharmacy Price Tracker are provided below. For information on audit history resulting from changes made through Drug Enter/Edit and Pharmacy Price Tracker, see Section 1.3.1.2.


User Manual

Subj: DRUG ENTER/EDIT AUDIT (264:ACETAMINOPHEN 650MG RTL SUPP) [#294225] 01/03/18@09:12 11 lines From: DOCTOR,ALPHA In 'IN' basket. Page 1 ------------------------------------------------------------------------------- Please Note: The Drug Enter/Edit option was used by DOCTOR,ALPHA. The drug that was entered/edited was ACETAMINOPHEN 650MG RTL SUPP. ------------------------------------------------------------------------------- PRICE PER ORDER UNIT OLD: 15.54 NEW: 13.54 PRICE PER DISPENSE UNIT OLD: 0.1554 NEW: 0.1354

Drug Enter/Edit Message Example

Subj: Pharmacy Price Tracker [#294226] 01/03/18@09:12 2 lines From: POSTMASTER In 'IN' basket. Page 1 ------------------------------------------------------------------------------- DOCTOR,ALPHA has changed the PRICE PER DISPENSE UNIT of: ACETAMINOPHEN 650MG RTL SUPP to: 0.1354

Pharmacy Price Tracker Message Example

Not all fields in the DRUG file are subject to audit. Auditable fields are:

• GENERIC NAME (#.01)

• VA CLASSIFICATION (#2)

• DEA, SPECIAL HDLG (#3)

• MAXIMUM DOSE PER DAY (#4)

• STANDARD SIG (#5)

• FSN (#6)

• WARNING LABEL (#8)

• MESSAGE (#101)

• PHARMACY ORDERABLE ITEM (#2.1)

• RESTRICTION (#102)

• APPLICATION PACKAGES’ USE (#63)

• NDC (#31)

• CMOP DISPENSE (#213)

• ATC MNEMONIC (#212.2)

• REORDER LEVEL (#11)


User Manual

• ORDER UNIT (#12)

• PRICE PER ORDER UNIT (#13)

• PRICE PER DISPENSE UNIT (#16)

• SOURCE OF SUPPLY (#17)

• DISPENSE UNIT (#14.5)

• CURRENT INVENTORY (#50)

• DAW CODE (#81)

• NCPDP DISPENSE UNIT (#82)

• NCPDP QUANTITY MULTIPLIER (#83)

• INACTIVE DATE (#100)

• NATIONAL DRUG FILE ENTRY (#20)

• VA PRODUCT NAME (#21)

• PSNDF VA PRODUCT NAME ENTRY (#22)

• PACKAGE SIZE (#23)

• PACKAGE TYPE (#24)

• NATIONAL DRUG CLASS (#25)

• CMOP ID (#27)

• NATIONAL FORMULARY INDICATOR (#29)

• EPHARMACY BILLABLE (#84)

• EPHARMACY BILLABLE (TRICARE) (#85)

• EPHARMACY BILLABLE (CHAMPVA) (#86)

• SENSITIVE DIAGNOSIS DRUG (#87)

If a user makes changes to an auditable field, then the mail message Subject line displays the title DRUG ENTER/EDIT AUDIT along with the Internal Entry Number (IEN) and name of the drug. The message body shows the date/time of the change, the name of the user who made the change, and before/after descriptions of the changed field(s). If a user makes changes to a non-auditable field, or views any field but does not make changes, then the mail message Subject line displays the title DRUG ENTER/EDIT ACCESS along with the drug IEN and name. The message body indicates “No Audited Changes Made.” A designated mail coordinator must modify the PSS DEE AUDIT mail group to include the necessary recipients.

1.3.1.2 Drug Price Audit History

Patch PSS*1*227 provides an audit history for price changes made in the DRUG file (#50).

When the PRICE PER DISPENSE UNIT field (#16) is added or changed, or when the PRICE

PER DISPENSE UNIT field is automatically updated by a change to the PRICE PER ORDER

UNIT field (#13), the system will store the following data in the DT/TM DISP UNIT PRICE

CHANGED field (#50.095) in the DRUG file: the date and time of the update; the user who

updated the field; and the new value in the PRICE PER DISPENSE UNIT field. The DT/TM


User Manual

DISP UNIT PRICE CHANGED field is searchable via FileMan, and is viewable using either

FileMan or the Lookup into Dispense Drug File [PSS LOOK] option.

The PSS DRUG AUDIT RETENTION MOS parameter is used to limit the historical data held in

the DT/TM DISP UNIT PRICE CHANGED field. This parameter can be set to a positive whole

number of retention months. The time period for retaining historical data is based on the last date

of a price change, minus the parameter value (retention months) times 30 days. That is, the

retention period is based on 30-day months, counting back from the last price change. Only those

entries that fall within this time period will be stored in the file multiple. If the parameter is not

set to a whole number of retention months, then all entries in the DT/TM DISP UNIT PRICE

CHANGED field will be retained.

Follow the steps below to set the PSS DRUG AUDIT RETENTION MOS parameter, if a time

period for storing historical data is required. To set the parameter, contact a VistA programmer,

Clinical Application Coordinator, or similar user with access to the General Parameter Tools

[XPAR MENU TOOLS] option in VistA.

1. Log in to VistA.

2. At the "Select OPTION NAME:" prompt, type XPAR MENU TOOLS and then press Enter.

3. At the "Select General Parameter Tools Option:" prompt, type EP and then press Enter.

4. At the "Select PARAMETER DEFINITION NAME:" prompt, type PSS DRUG AUDIT

RETENTION MOS and then press Enter.

5. At the "NUMBER OF MONTHS:" prompt, type the number of retention months and then

press Enter.

1.4 Order Check Management [PSS ORDER CHECK MANAGEMENT]

Note: Dosing Checks during Drug Order Entry will be available only with the release of

MOCHA v2.0.

The Order Check Management [PSS ORDER CHECK MANAGEMENT] option sub-menu

provides options to request custom changes to the Enhanced Order Check (drug interaction,

duplicate therapy, and dosing) vendor database. It also allows the user to review drug

interactions and their severity, which have been added locally to the DRUG INTERACTION file

(#56) in order to determine whether the same changes need to be requested as custom changes to

the new vendor database.


User Manual

1.4.1 Request Changes to Enhanced Order Check Database [PSS ORDER CHECK CHANGES]

The Request Changes to Enhanced Order Check Database [PSS ORDER CHECK CHANGES]

option allows Pharmacy users to request custom changes to the Enhanced Order Check (drug

interaction, duplicate therapy and dosing) vendor database. The user can request the following

custom changes:

• Add a new drug interaction

• Change an existing drug interaction severity

• Change to a duplicate therapy

• Change to a dosing record for a drug

Note that although the ability to request a custom dosing record change is available with

the release of MOCHA v1.0, the introduction of dosing order checks via backdoor

Pharmacy will be available only with MOCHA v2.0.

Depending on the request, the user is prompted for different pieces of information.

The request is directed to an Outlook mail group ([email protected])

that will review and act on the requests. A copy of the request is also sent to the user’s VistA

email account. If the user is not ready to send the request just yet, answering ‘No’ at the transmit

prompt will send the request just to the user’s VistA email account. Once the user is ready to

send the request, if no changes are needed, the user can retrieve the VistA email message and

forward it to the Outlook mail group (VAOITVHITPSCUSTOMREQ). If the VistA email

message is no longer available for retrieval, the user must reenter and transmit the request.

Note: The option will use whatever editor (line or screen) the user has defined for his or

her “Preferred editor” in the NEW PERSON file (#200).

Example 1: Requesting to Add a New Drug Interaction

Select Pharmacy Data Management Option: ORDER CHECK Management

Select Order Change Management Option: REQuest Changes to Enhanced Order Check Database


N - New Drug Interaction

S - Drug Interaction Severity Change

T – Duplicate Therapy Change

D – Dosing Change

Select one of the choices above, for instance: N ew Drug Interaction

Enter Interacting Drug Names (free text): Drug A & Drug B


1- Critical

2- Significant

Enter Severity: 1

You must now enter a reason or references for this request. <word processing>


User Manual

Press Return to continue, '^' to exit:

1> This is a request to add a new Drug-Drug Interaction.

2>

EDIT Option:

NOTE: This is a test account. Regardless of your response to the 'Transmit' prompt, this

request will NOT be sent forward for national review.

Transmit New Drug Interaction Request? Y// NO

Mail message only sent to you in Vista Mail.


Example of Email Message:

Subj: New Drug Interaction Request [#89442] 05/28/08@12:51 4 lines

From: PHARMACIST,TWENTYTHREE In 'IN' basket. Page 1

-------------------------------------------------------------------------

Request New Drug Interaction:

DRUG A NAME & DRUG B NAME

Severity:

CRITICAL

This is a request to add a new Drug Interaction.


Subj: New Drug Interaction Request [#89442] 05/28/08@12:51 4 lines

From: PHARMACIST,TWENTYTHREE In 'IN' basket.


PHARMACIST,TWENTYTHREE Last read: 05/28/08@12:52 [First read: 05/28/08@12:51]


Example 2: Requesting a Drug Interaction Severity Change


Select Order Check Management Option: REQuest Changes to Enhanced Order Check Database


N – New Drug Interaction

S – Drug Interaction Severity Change


D – Dosing Change

Select one of the choices above, for instance: S Drug Interaction Severity Change

Enter Interacting Drug Names (free text): Drug A & Drug B


1- Critical

2- Significant

Change Severity To: 1

You must now enter a reason or references for this request <word processing>.


1> This is a Drug Interaction severity change request.

2>


User Manual

EDIT Option:


request will NOT be sent forward for national review.


Transmit Drug Interaction Severity Change Request? Y// YES



Subj: Drug Interaction Severity Change Request [#89442] 05/28/08@12:51 4 lines


-------------------------------------------------------------------------

Drug-Drug Interaction:

DRUG A NAME & DRUG B NAME

Severity Change To:

CRITICAL

This is a Drug Interaction severity change request.


Subj: Drug Interaction Severity Change Request [#89442] 05/28/08@12:51 4 lines





Example 3: Requesting a Duplicate Therapy Change


Select Order Check Management Option: REQuest Changes to Enhanced Order Check Database


N – New Drug Interaction

S – Drug Interaction Severity Change


D – Dosing Change

Select one of the choices above, for instance T Duplicate Therapy Change

You must now enter a description of the change/problem. <word processing>


1> This is a Duplicate Therapy change request.

2>

EDIT Option:

Transmit Duplicate Therapy Change Request? Y// es


request will NOT be sent forward for national review



Subj: Duplicate Therapy Change Request [#89442] 05/28/08@12:51 4 lines


-------------------------------------------------------------------------

Duplicate Therapy Change Description/Problem:

This is a Duplicate Therapy change request.


Subj: Duplicate Therapy Change Request [#89442] 05/28/08@12:51 4 lines



User Manual




Example 4: Requesting a Dosing Change

Select Order Check Management Option: REQuest Changes to Enhanced Order Check Da

tabase


N New Drug Interaction

S Drug Interaction Severity Change

T Duplicate Therapy Change

D Dosing Change

Select one of the above: Dosing Change

You must now enter a description of the change/problem. <word processing>


1>No dosing information available for a 81 yo on Drug A.

2>

EDIT Option:

NOTE: This is a test account. Regardless of your response to the 'Transmit'

prompt, this request will NOT be sent forward for national review.

Transmit Dosing Change Request? Y// ES




Subj: Dosing Change Request [#57209] 08/12/10@10:55 3 lines


-------------------------------------------------------------------------------

Dosing Change Description/Problem:

No dosing information available for a 81 yo on Drug A.


Subj: Dosing Change Request [#57209] 08/12/10@10:55 3 lines


Local Message-ID: [email protected] (1 recipient)



1.4.2 Report of Locally Entered Interactions [PSS REPORT LOCAL INTERACTIONS]

The Report of Locally Entered Interactions [PSS REPORT LOCAL INTERACTIONS] option

allows sites to print a report of locally entered drug interactions and their severity. This

information can be used to determine whether or not a change request needs to be made to the

enhanced order check database.


User Manual

Example: Requesting to Print a Report of Locally Entered Drug Interaction and Their Severity


Select Order Check Management Option: REPort of Locally Entered Interactions

This report gives you a printed copy of locally added drug interactions and their severity.

You may queue the report to print, if you wish.

DEVICE: VIRTUAL Right Margin: 80//

LOCALLY ADDED DRUG INTERACTION LIST FEB 22,2010 15:26 PAGE 1

NAME SEVERITY

--------------------------------------------------------------------------------

DIGITALIS/DIPHENHYDRAMINE SIGNIFICANT

ALPRAZOLAM/COLCHICINE CRITICAL

AMOXICILLIN/CISAPRIDE CRITICAL

AMINOPHYLLINE/AZITHROMYCIN CRITICAL

AZITHROMYCIN/THEOPHYLLINE CRITICAL

AZITHROMYCIN/OXTRIPHYLLINE CRITICAL

AMPICILLIN/ASCORBIC ACID CRITICAL

ASCORBIC ACID/ATENOLOL SIGNIFICANT

ACACIA/ACETIC ACID SIGNIFICANT

AMIKACIN/ASPIRIN SIGNIFICANT

ASCORBIC ACID/ASPIRIN CRITICAL

CHLORPHENIRAMINE/HYDROXYZINE CRITICAL

Select Order Check Management Option:

1.5 Electrolyte File (IV) [PSSJI ELECTROLYTE FILE]

The Electrolyte File (IV) [PSSJI ELECTROLYTE FILE] option allows the contents of the

DRUG ELECTROLYTES file (#50.4) to be altered. This file contains the names of

anions/cations and their concentration units. The file provides the ability for sites to enter

intravenous (IV) orders for electrolytes as individual ingredients so that the IV label will print

the total of individual electrolytes rather than the additive names. The ELECTROLYTES

multiple (#8) in the IV ADDITIVES file (#52.6) and the ELECTROLYTES multiple (#4) of the

IV SOLUTIONS file (#52.7) point to this Electrolyte file.

Example 1: Electrolyte file (#50.4) (Adding)

Select Pharmacy Data Management Option: ELectrolyte File (IV)

Select DRUG ELECTROYTES NAME: CHLORIDE MEQ/ML

ARE YOU ADDING ‘CHLORIDE’ AS A NEW DRUG ELECTROLYTES (THE 9TH)? Y (YES)

DRUG ELECTROLYTES CONCENTRATION UNITS: MEQ/ML

NAME: CHLORIDE// <Enter>

CONCENTRATION UNITS: <Enter>

Select DRUG ELECTROLYTES NAME: <Enter>

Example 2: Electrolyte file (#50.4) (Deleting)

Select Pharmacy Data Management Option: ELectrolyte File (IV)

Select DRUG ELECTROLYTES NAME: CHLORIDE

NAME: CHLORIDE// @ SURE YOU WANT TO DELETE THE ENTIRE ‘CHLORIDE’ DRUG ELECTROLYTES? Y (YES)


User Manual

1.6 Lookup into Dispense Drug File [PSS LOOK]

The Lookup into Dispense Drug File [PSS LOOK] option provides a lookup into the DRUG file

(#50) and displays fields that are commonly edited. It is not possible to edit entries in the DRUG

file (#50) from this option. Edits can be made through the use of the Drug Enter/Edit option.

Patch PSS*1*61 ensures that the newly populated CS FEDERAL SCHEDULE field (#19) of the

VA PRODUCT file (#50.68) is also included as part of the drug details in the Lookup into

Dispense Drug File [PSS LOOK] option. Patch PSS*1*147 adds the NUMERIC DOSE sub-

field (#5) of the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) and DOSE

UNIT sub-field (#4) of the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50)

defined for Local Possible Dosages to the display. Patch PSS*1*192 adds EPHARMACY

BILLABLE (#84), EPHARMACY BILLABLE (TRICARE) (#85), EPHARMACY BILLABLE

(CHAMPVA) (#86), and SENSITIVE DIAGNOSIS DRUG (#87). Patch PSS*1*200 add the

display of Copay Tier sub-field (#.01) and Copay Effective Date sub-field (#1) from the VA

PRODUCT file (#50.6) for Fixed Medication Copayment Tiers.

Patch PSS*1*227 adds the date and time of the last drug price addition or change, the user who

made the change, and the new value in the PRICE/DISPENSE UNIT field shown in the display

below. This value is taken from the PRICE PER DISPENSE UNIT field (#16) in the DRUG file

(#50). For additional details on DRUG file audits introduced by this patch, see Section 1.3.1.

Example 1: Lookup into Dispense Drug File [PSS LOOK] Option

Select DRUG GENERIC NAME: TIMOLOL

1 TIMOLOL MALEATE 0.25% OPH GEL OP101 N/F NATL N/F; 2.5 ML/TUBE

2 TIMOLOL MALEATE 0.25% OPH SOLN OP101 NATL REVIEW; 5 ML/BT (IEN)

3 TIMOLOL MALEATE 0.5% OPH GEL OP101 N/F NATL N/F; 2.5 ML/TUBE (IEN)

4 TIMOLOL MALEATE 0.5% OPH SOLN OP101 NATL REVIEW; 5 ML/BT (IEN)

CHOOSE 1-4: 4 TIMOLOL MALEATE 0.5% OPH SOLN OP101 NATL REVIEW;

5 ML/BT (IEN)

TIMOLOL MALEATE 0.5% OPH SOLN

=============================================================================

VA PRINT NAME: TIMOLOL MALEATE 0.5% OPH SOLN CMOP ID#: T0056

VA PRODUCT NAME: TIMOLOL MALEATE 0.5% SOLN,OPH CMOP DISPENSE: NO

ORDERABLE ITEM: TIMOLOL SOLN,OPH NDF DF: SOLN,OPH

ORDERABLE ITEM TEXT:

SYNONYM(S): TIMOPTIC 0.5% Trade Name

T/5 Quick Code

T.5 Quick Code

024208032405 Drug Accountability

1677 Quick Code

MESSAGE: NATL REVIEW; 5 ML/BT (IEN)

-----------------------------------------------------------------------------

DEA, SPECIAL HDLG: 6P NDC: 61314-227-05

DAW CODE: 5 – SUBSTITUTION ALLOWED-BRAND DRUG DISPENSED AS A GENERIC


INACTIVE DATE:

QUANTITY DISPENSE MESSAGE: ML (5/BT)

WARNING LABEL SOURCE is set to 'NEW'

NEW WARNING LABEL:

22N For the eye.

Pharmacy fill card display: DRUG WARNING 22N

-----------------------------------------------------------------------------

ORDER UNIT: BT PRICE/ORDER UNIT: 1.45

DISPENSE UNIT: ML VA DISPENSE UNIT: ML


User Manual

DISPENSE UNITS/ORDER UNIT: 5 PRICE/DISPENSE UNIT: 0.2900

DATE PRICE/DISPENSE UNIT LAST CHANGED: MAR 17, 2017@12:13:36

BY: DOE, JOHN VALUE: 0.2900

MAXIMUM DAYS SUPPLY:

NCPDP DISPENSE UNIT: EACH NCPDP QUANTITY MULTIPLIER: 1.00001

ePharmacy Billable: YES

ePharmacy Billable (TRICARE): ePharmacy Billable (CHAMPVA):


APPL PKG USE: Outpatient Unit Dose

STRENGTH: UNIT:

POSSIBLE DOSAGES:


LOCAL POSSIBLE DOSAGE: 1 DROP PACKAGE: IO

BCMA UNITS PER DOSE: 1

NUMERIC DOSE: 1 DOSE UNIT: DROP(S)

LOCAL POSSIBLE DOSAGE: 2 DROPS PACKAGE: IO

BCMA UNITS PER DOSE: 1

NUMERIC DOSE: 2 DOSE UNIT: DROP(S)

-----------------------------------------------------------------------------

VA CLASS: OP101 BETA-BLOCKERS,TOPICAL OPHTHALMIC

LOCAL NON-FORMULARY: VISN NON-FORMULARY:

National Formulary Indicator: YES

Copay Tier:


National Restriction:

Local Drug Text:

Example 2: Lookup into Dispense Drug File [PSS LOOK] Option

Select Pharmacy Data Management Option: LOOKUP INTO Dispense Drug File

Select DRUG GENERIC NAME: LOVASTATIN 20MG TAB CV350 N/F

RESTRICTED TO CARDIOLOGY SERVICE

LOVASTATIN 20MG TAB

============================================================================

VA PRINT NAME: LOVASTATIN 20MG TAB CMOP ID#: L0060

VA PRODUCT NAME: LOVASTATIN 20MG TAB CMOP DISPENSE: YES

ORDERABLE ITEM: LOVASTATIN TAB (N/F) NDF DF: TAB


Refer to PBM/MAP Hyperlipidemia treatment guidelines for use.

SYNONYM (S): MEVACOR Trade Name

MESSAGE: THIS IS RESTRICTED TO CARDIOLOGY SERVICE

-----------------------------------------------------------------------------

DEA, SPECIAL HDLG: 6 NDC: 000006-0731-82


INACTIVE DATE:

QUANTITY DISPENSE MESSAGE: DISPENSE IN 30'S

WARNING LABEL: WITH FOOD

-----------------------------------------------------------------------------

ORDER UNIT: BT PRICE/ORDER UNIT: 50

DISPENSE UNIT: TAB VA DISPENSE UNIT: TAB

NCPDP DISPENSE UNIT: EACH NCPDP QUANTITY MULTIPLIER: 1.00001

ePharmacy Billable: YES

ePharmacy Billable (TRICARE): ePharmacy Billable (CHAMPVA):


DISPENSE UNITS/ORDER UNIT: 100 PRICE/DISPENSE UNIT: 0.500

DATE PRICE/DISPENSE UNIT LAST CHANGED: MAR 17, 2017@12:13:36

BY: DOE, JOHN VALUE: 0.500


APPL PKG USE: Outpatient Unit Dose

-----------------------------------------------------------------------------

VA CLASS: CV350 ANTILIPEMIC AGENTS

LOCAL NON-FORMULARY: N/F VISN NON-FORMULARY: N/F

National Formulary Indicator: YES

Copay Tier:


FORMULARY ALTERNATIVES: SIMVASTATIN 20MG TAB

PRAVASTATIN 20MG TAB

National Restriction:

(Refer to PBM/MAP Hyperlipidemia treatment guidelines for use)

Local Drug Text:


User Manual

Example 3: Lookup into Dispense Drug File [PSS LOOK] - Looking Up a Non-VA Med

Select DRUG GENERIC NAME: GINKO TAB/CAP HA000 N/F

ginko tab/cap

=============================================================================

VA PRODUCT NAME: GINKGO EXT 60MG TAB

ORDERABLE ITEM: ginko TAB (N/F) NDF DF: TAB


SYNONYM(S):

MESSAGE:

-----------------------------------------------------------------------------

DEA, SPECIAL HDLG: NDC:


INACTIVE DATE:

-----------------------------------------------------------------------------

ORDER UNIT: PRICE/ORDER UNIT:

DISPENSE UNIT:

DISPENSE UNITS/ORDER UNIT: PRICE/DISPENSE UNIT:


APPL PKG USE: Non-VA Med

STRENGTH: UNIT:

POSSIBLE DOSAGES:


-----------------------------------------------------------------------------

VA CLASS:

LOCAL NON-FORMULARY: N/F VISN NON-FORMULARY:

National Formulary Indicator: Not Matched to NDF

Copay Tier:


Example 4: Inquire to VA Product Info For Local Drug [PSNLOOK] Option (showing a maximum days

supply of 365)

Inquire to VA Product Info For Local Drug [PSNLOOK]

Select OPTION NAME: PSNLOOK Select DRUG GENERIC NAME: PRIMIDONE 250MG TAB

CN400

DRUG Generic Name: PRIMIDONE 250MG TAB

VA Product Name: PRIMIDONE 250MG TAB

VA Generic Name: PRIMIDONE

Dosage Form: TAB

Strength: 250 Units: MG

National Formulary Name: PRIMIDONE TAB

VA Print Name: PRIMIDONE 250MG TAB

VA Product Identifier: P0116 Transmit To CMOP: YES

VA Dispense Unit: TAB

PMIS: PRIMIDONE - ORAL

Active Ingredients:

PRIMIDONE Str: 250 Unt: MG


Primary Drug Class: CN400

CS Federal Schedule: 0 Unscheduled

Single/Multi Source Product: Multi

Max Single Dose: Min Single Dose:

Max Daily Dose: Min Daily Dose:

Max Cumulative Dose:

National Formulary Indicator: Yes

Copay Tier:


User Manual


Override DF Exclude from Dosage Checks: No

Auto-Create Default Possible Dosage? No

Possible Dosages To Auto-Create: 1x Possible Dosage

Package: Both Inpatient and Outpatient

Maximum Days Supply: <<<< Displays value in the VA PRODUCT FILE (#50.68)

Example 5: Inquire to National Files [PSNACT] Option (showing a maximum days supply of 365)

Select OPTION NAME: PSNACT Inquire to National Files

VA Product Name: ACCU-CHEK AVIVA (GLUCOSE) 1-2 CONTROL SOLN

VA Generic Name: GLUCOSE CONTROL

Dose Form: SOLN,CONTROL (Exclude from Dosing Cks)

Strength: Units:

National Formulary Name: GLUCOSE CONTROL SOLN,CONTROL

VA Print Name: ACCU-CHEK AVIVA 1-2 CONTROL SOLN

VA Product Identifier: A1331 Transmit to CMOP: Yes VA Dispense Unit: EA

PMIS: None

Active Ingredients:

Primary VA Drug Class: DX900

Secondary VA Drug Class:

CS Federal Schedule: 0 Unscheduled

National Formulary Indicator: Yes

National Formulary Restriction:

Copay Tier:


Exclude Drg-Drg Interaction Ck: Yes (No check for Drug-Drug Interactions)

Override DF Exclude from Dosage Checks: No

Auto-Create Default Possible Dosage? Yes

Maximum Days Supply: <<<< Displays value in the VA PRODUCT FILE (#50.68)

1.7 Medication Instruction Management [PSS MED INSTRUCTION MANAGEMENT]

The Medication Instruction Management [PSS MED INSTRUCTION MANAGEMENT] option

sub-menu provides options through which the user can review and manage entries in the

MEDICATION INSTRUCTION file (#51).

1.7.1 Medication Instruction File Add/Edit [PSSJU MI]

The Medication Instruction File Add/Edit [PSSJU MI] option allows the user to enter and edit

abbreviations and expansions in the MEDICATION INSTRUCTION file (#51) and to “flag”

those entries for use by the Inpatient Medications package only, Outpatient Pharmacy package

only, or both. The expansions in the MEDICATION INSTRUCTION file (#51) expand the

Schedule and Patient Instructions when building the SIG. The Inpatient Medications package

contains a field called SPECIAL INSTRUCTIONS that utilizes these abbreviations and

expansions when printing various reports. Additionally, the Outpatient Pharmacy package

utilizes these abbreviations for expansions when building the prescription SIG.


User Manual

The Medication Instruction File Add/Edit [PSSJU MI] option allows the user to enter the

expansion in a language other than English. PDM does not translate English terms into another

language; instead, it allows the user to enter a translation of a term. If a value has not been

entered in the OTHER LANGUAGE EXPANSION field (#1.1), PDM defaults to the value

entered in the EXPANSION field (#1). If no values exist in the EXPANSION field (#1) and

OTHER LANGUAGE EXPANSION field (#1.1), an EXPANSION value will not print when

Outpatient Pharmacy builds the SIG. See Appendix F for a list of Spanish equivalents for some

of the more common medication instructions.

Patch PSS*1*201 adds three new fields to the Medication Instruction File Add/Edit PSSJU MI]

option. The DOSING CHECK FREQUENCY field (#32) allows a user to enter a specific format

pattern to represent the frequency such as ‘X#D’, where ‘#’ represents a 1-2 character numeric

value. The DOSING CHECK FREQUENCY field takes priority over all other fields/values in

this file when determining frequency for the Max Daily Dose Order Check. If the DOSING

CHECK FREQUENCY value is not used, the FREQUENCY (IN MINUTES) value will be used

for the Max Daily Dose Order Check. The new fields in the MEDICATION INSTRUCTION file

(#51) will only be utilized when performing the Max Daily Dose Order Check for outpatient

medication orders and only after a frequency value could not be determined from the

ADMINISTRATION SCHEDULE File (#51.1).

The DRUG(S) FOR DOSING CHK FREQ field (#32.1) is a multiple field that allows for

dispense drugs from the DRUG file (#50) to be associated with the DOSING CHECK

FREQUENCY field (#32) value within the MEDICATION INSTRUCTION file (#51).

• When a value is entered in the DOSING CHECK FREQUENCY field and NO drug(s)

are entered in the DRUG(S) FOR DOSING CHK FREQ field, the Max Daily Dose Order

Check will use the value in the DOSING CHECK FREQUENCY field to derive a

frequency for all orders whose medication instruction is derived from the schedule.

• When a value is entered for DOSING CHECK FREQUENCY field and there are one or

more drug(s) entered in the DRUG(S) FOR DOSING CHK FREQ field, the Max Daily

Dose Order Check will ONLY use the value in DOSING CHECK FREQUENCY to

derive a frequency if the order that has that medication instruction, derived from the

schedule, also matches one of the drug(s) entered. If the drug found in the order does not

match a drug listed in the DRUG(S) FOR DOSING CHK FREQ field, then the value of

the DOSING CHECK FREQUENCY will not be used for the Max Daily Dose Order

Check to derive a frequency.


User Manual

Example : Medication Instruction File Add/Edit [PSSJU MI] Option

Select Pharmacy Data Management Option: MEDIC

1 Medication Instruction Management

2 Medication Routes Management

CHOOSE 1-2: 1 Medication Instruction Management

Select Medication Instruction Management Option: MEDIC

1 Medication Instruction File Add/Edit

2 Medication Instruction File Report

CHOOSE 1-2: 1 Medication Instruction File Add/Edit

Select MEDICATION INSTRUCTION NAME: QIDPC

Lookup: NAME

QIDPC FOUR TIMES A DAY AFTER MEALS & AT BEDTIME

...OK? Yes// (Yes)

NAME: QIDPC//

SYNONYM: QIDPCHS//

EXPANSION: FOUR TIMES A DAY AFTER MEALS & AT BEDTIME//

PLURAL:

INTENDED USE: IN & OUTPATIENT//

DOSING CHECK FREQUENCY: ?


The numeric limit is 99, except for the following formats:

Q#W - Maximum 28 weeks allowed

Q#L - Maximum 6 months allowed

Enter '??' to view the available dosing check frequency formats

for this field.

DOSING CHECK FREQUENCY: ??

The DOSING CHECK FREQUENCY field takes priority over all other

fields/values when determining frequency.

PLEASE BE AWARE that the format of the frequency in this field must

employ the format patterns of the vendor database, which always places

the numeric value in the middle position of the medication instruction.

In some cases an 'X' (symbol for 'times') must be entered as the first

character, although it is still translated as the number of times per

designated period.

The text examples within the following brackets [] provide clarification

of the literal medication instruction translation for the possible

formats. Enter the dosing check frequency in one of the following

specified formats (# represents a whole number):

Q#H [every # hour(s), such as every 5 hours]

Q#D [every # day(s), such as every 3 days]

Q#W [every # week(s), such as every 5 weeks]

Q#L [every # month(s), such as every 3 months]

X#D [times per day, such as 17 times per day]

X#W [times per week, such as 3 times per week]

X#L [times per month, such as 4 times per month]

Numeric value can be 1-2 characters.

DOSING CHECK FREQUENCY:

Select DRUG(S) FOR DOSING CHK FREQ: ?

You may enter a new DRUG(S) FOR DOSING CHK FREQ, if you wish


User Manual

Select a dispense drug to be associated with the dosing check

frequency.

Answer with DRUG NUMBER, or GENERIC NAME, or VA PRODUCT NAME, or

NATIONAL DRUG CLASS, or NDC, or APPLICATION PACKAGES' USE, or

ATC MNEMONIC, or DRUG TEXT ENTRY, or SYNONYM

Do you want the entire 1804-Entry DRUG List? N (No)

Select DRUG(S) FOR DOSING CHK FREQ:??


This field allows a dispense drug from the DRUG (#50) file to be

associated with the DOSING CHECK FREQUENCY (#32) field value within

the MEDICATION INSTRUCTION (#51) file.

When a value is entered for "DOSING CHECK FREQUENCY:" and NO drug(s) is

entered for "Select DRUG(S) FOR DOSING CHK FREQ:", the dosing check will

use the value for "DOSING CHECK FREQUENCY:" to derive a frequency for

all orders that have that medication instruction.

When a value is entered for "DOSING CHECK FREQUENCY:" and a drug(s) is

entered for "Select DRUG(S) FOR DOSING CHK FREQ:", the Daily Dose Order

Check will ONLY use the value in "DOSING CHECK FREQUENCY:" to derive

a frequency if the order that has that medication instruction also

matches one of the drug(s) entered. If the drug found in the order does

not match a drug listed in the DRUG(S) FOR DOSING CHK FREQ field, then

the value of the DOSING CHECK FREQUENCY will not be used for the Daily

Dose Order Check.

FREQUENCY (IN MINUTES): <Enter>

Select OLD MED INSTRUCTIONS NAME(S):<Enter>

The third field added by patch PSS*1*201, OLD MED INSTRUCTION NAME(S) (#33), is a

multiple field which is automatically populated by the software when the user modifies the

NAME field (#.01) of the medication instruction. Values can also be added to this field directly.

More than one old med instruction name is allowed for a medication instruction. No two

medication instructions can have the same old med instruction name. An old med instruction

name must be unique among all NAME(S), SYNONYM(S) and other OLD MED

INSTRUCTION NAME(S). The OLD MED INSTRUCTION NAME(S) field (#33) along with

the SYNONYM field (#.5) will used to lookup a schedule entered for an order to derive a

frequency value for the Max Daily Dose Order Check.

Example : Edit Medication Instruction Name

The modified name ‘FIT’ is automatically added to the OLD MED INSTRUCTION NAME(S)

multiple when the medication instruction name is edited to ‘FITCH’.

Select Pharmacy Data Management Option: MED




Select Medication Instruction Management Option: MED



CHOOSE 1-2: 1 Medication Instruction File Add/Edit

Select MEDICATION INSTRUCTION NAME: FIT

Lookup: NAME

FIT FOR ITCHING

...OK? Yes// (Yes)

NAME: FIT// FITCH

SYNONYM:

EXPANSION: FOR ITCHING//


User Manual

PLURAL:



Select DRUG(S) FOR DOSING CHK FREQ:

FREQUENCY (IN MINUTES):

Select OLD MED INSTRUCTION NAME(S):

Select MEDICATION INSTRUCTION NAME: FITCH

Lookup: NAME

FITCH FOR ITCHING

...OK? Yes// (Yes)

NAME: FITCH//

SYNONYM:

EXPANSION: FOR ITCHING//

PLURAL:





Select OLD MED INSTRUCTION NAME(S): ?

Answer with OLD MED INSTRUCTION NAME(S):

FIT

You may enter a new OLD MED INSTRUCTION NAME(S), if you wish


Example : Attempt to add new Synonym with same name as existing Old Med Instruction Name in file

The action is blocked when a user attempts to add a new synonym with the same name as an

existing old med instruction name in the file. A notification is displayed with the medication

instruction name and internal entry number in parenthesis for which the duplicate old med

instruction name exists.

Duplicate Old Med Instruction is found in another entry

Select MEDICATION INSTRUCTION NAME: QIDHS FOUR TIMES A DAY AND AT BEDTIME

NAME: QIDHS//

SYNONYM: QID&HS??

Answer must be 1 to 9 characters in length, and must be unique among all

NAME(S), SYNONYM(S), and OLD MED INSTRUCTION NAME(S).

Duplicate exists in Old Med Instruction Name multiple for

the entry QIDPC (96) in the file. Please enter a new name.

SYNONYM:

Duplicate Old Med Instruction is found in the entry the user is editing


NAME: QIDHS//

SYNONYM: 4XDHS??




this entry. Please enter a new name.

SYNONYM:

Example : Attempt to edit medication instruction name to match existing old med instruction name in file

A notification is displayed and the action is blocked when a user attempts to edit a medication

instruction name to match an existing old med instruction name in the MEDICATION


User Manual

INSTRUCTION file (#51). The same actions will take place if a user attempted to edit a

synonym to match an existing old med instruction name in the file.

Duplicate Old Medication Instruction Name is found in entry user is editing Select MEDICATION INSTRUCTION NAME: QIDHS FOUR TIMES A DAY AND AT BEDTIME

NAME: QIDHS// 4XDHS??



A duplicate exists in the OLD MED INSTRUCTION NAME(S) multiple

for this entry.

NAME: QIDHS//

Duplicate Old Schedule Name is found in another entry


NAME: QIDHS// QID&HS??



A duplicate exists in the OLD MED INSTRUCTION NAME(S) multiple

for the entry QIDPC (96).

NAME: QIDHS//

Example : Attempt to directly enter Old Med Instruction Name that is a duplicate of an existing Old Med

Instruction Name in file

If a user attempts to directly enter an old med instruction name that is a duplicate of an existing

old med instruction name somewhere in the file, the action is blocked and a notification is

displayed.



NAME: QIDHS//

SYNONYM:

EXPANSION: FOUR TIMES A DAY AND AT BEDTIME Replace

OTHER LANGUAGE EXPANSION:

PLURAL:





Select OLD MED INSTRUCTION NAME(S): 4XDHS// 4XDHS

OLD MED INSTRUCTION NAME(S): 4XDHS// QID&HS??

Answer must be 1-9 characters in length, and must be unique among all



the entry QIDPC (96) in the file.

OLD MED INSTRUCTION NAME(S): 4XDHS//

Duplicate Old Medication Instruction Name is found in entry user is editing


NAME: QIDHS//

SYNONYM:



PLURAL:





Select OLD MED INSTRUCTION NAME(S): 4XHS// 4XHS

OLD MED INSTRUCTION NAME(S): 4XHS// 4XDHS??


User Manual




this entry.

OLD MED INSTRUCTION NAME(S): 4XHS//

Example: Attempt to directly edit an old med instruction name to match an existing NAME field or

SYNONYM field anywhere in the file

If a user attempts to directly edit an old med instruction name to match an existing NAME field

or SYNONYM field anywhere in the MEDICATION INSTRUCTION file (#51), the action will

be blocked and a notification displayed.


NAME: QIDHS//

SYNONYM: 4XHS



PLURAL:





Select OLD MED INSTRUCTION NAME(S): 4XDHS// 4XDHS

OLD MED INSTRUCTION NAME(S): 4XDHS// QIDHS??



An OLD MED INSTRUCTION NAME(S) entry cannot be the same as an

existing NAME field.

OLD MED INSTRUCTION NAME(S): 4XDHS// 4XHS??



An OLD MED INSTRUCTION NAME(S) entry cannot be the same as an

existing SYNONYM field.

OLD MED INSTRUCTION NAME(S): 4XDHS//

1.7.2 Medication Instruction File Report [PSS MED INSTRUCTION REPORT]

The Medication Instruction File Report [PSS MED INSTRUCTION REPORT] option provides a report of entries from the MEDICATION INSTRUCTION (#51) File that shows whether or not data has been

entered in the FREQUENCY (IN MINUTES) (#31) Field.

The report can be run for all medication instructions or just the medication instructions without a

frequency. If the report is run for only those medication instructions with a missing frequency

and all medication instructions have a frequency, the report will display the message “No

Medication Instructions found without frequencies.“

The report can be set to print in either an 80 or 132 column format.

PSS*1*201 enhances the Medication Instruction File Report [PSS MED INSTRUCTION REPORT]

option to allow the display of data from three new fields; DOSING CHECK FREQUENCY field

(#32), DRUG(S) FOR DOSING CHK FREQ field (#32.1) and OLD MED INSTRUCTION

NAME(S) field (#33).


User Manual

Example 1: User selects all medication instructions

Select Pharmacy Data Management Option: med




Select Medication Instruction Management Option: MEDIC



CHOOSE 1-2: 2 Medication Instruction File Report

This report displays entries from the MEDICATION INSTRUCTION (#51) File. It

can be run for all Medication Instructions or only Medication Instructions

without a FREQUENCY (IN MINUTES). If a FREQUENCY (IN MINUTES) cannot be

determined for an order, the daily dosage check cannot occur for that order.


A All Medication Instructions

O Only Medication Instructions with a missing frequency

Print All Medication Instructions, or Only Medication Instructions

without a frequency: A// All Medication Instructions


80 80 Column

132 132 Column

Print report in 80 or 132 column format: 80// <ENTER> Column


(Report follows)

MEDICATION INSTRUCTION FILE REPORT (All) PAGE: 1

-----------------------------------------------------------------------------

AD

SYNONYM:

EXPANSION: RIGHT EAR


PLURAL:

INTENDED USE: OUTPATIENT ONLY


DRUG(S) FOR DOSING CHK FREQ:


OLD MED INSTRUCTION NAME(S):

BID

SYNONYM:

EXPANSION: TWICE A DAY


PLURAL:

INTENDED USE: IN & OUTPATIENT



FREQUENCY (IN MINUTES): 720


FCP

SYNONYM:

EXPANSION: FOR CHEST PAIN


PLURAL:






User Manual


Q1HWA

SYNONYM:

EXPANSION: EVERY ONE HOUR WHILE AWAKE


PLURAL:


DOSING CHECK FREQUENCY: X12D




Q12H

SYNONYM: Q12

EXPANSION: EVERY TWELVE HOURS


PLURAL:






Q5M

SYNONYM:

EXPANSION: EVERY 5 MINUTES


PLURAL:



DRUG(S) FOR DOSING CHK FREQ: NITROGLYCERIN 0.4MG TAB



Q46

SYNONYM: Q46H

EXPANSION: EVERY 4-6 HOURS


PLURAL:






QDAILY

SYNONYM: QDAY

EXPANSION: EVERY 4-6 HOURS


PLURAL:





OLD MED INSTRUCTION NAME(S): QD

QIDAC

SYNONYM: QIDACHS

EXPANSION: FOUR TIMES A DAY BEFORE MEALS & AT BEDTIME


PLURAL:






WM


User Manual

SYNONYM:

EXPANSION: WITH MEALS


PLURAL:






End of Report

Example 2: User selects only medication instructions without a frequency defined

MEDICATION INSTRUCTIONS WITHOUT FREQUENCY REPORT PAGE: 1

-----------------------------------------------------------------------------

AC

SYNONYM:

EXPANSION: BEFORE MEALS


PLURAL:






AD

SYNONYM:

EXPANSION: RIGHT EAR


PLURAL:






FCP

SYNONYM:

EXPANSION: FOR CHEST PAIN


PLURAL:






Q1HWA

SYNONYM:

EXPANSION: EVERY ONE HOUR WHILE AWAKE


PLURAL:






PC

SYNONYM:

EXPANSION: AFTER MEALS


PLURAL:







User Manual

WM

SYNONYM:

EXPANSION: WITH MEALS


PLURAL:





OLD MED INSTRUCTION NAME(S): WME

End of Report.

Example 3: Result if all medication instructions have a frequency defined

MEDICATION INSTRUCTIONS WITHOUT FREQUENCY REPORT PAGE: 1

-----------------------------------------------------------------------------

No Medication Instructions found without frequencies

1.8 Medication Routes Management [PSS MEDICATION ROUTES MGMT]

The Medication Routes Management [PSS MEDICATION ROUTES MGMT] menu contains 5

options that allow users to review and edit Local Medication Routes, request changes to Standard

Medication Routes, and view a report of default med routes for orderable items.

1.8.1 Medication Route File Enter/Edit [PSS MEDICATION ROUTES EDIT]

The Medication Route File Enter/Edit [PSS MEDICATION ROUTES EDIT] option provides

the ability to enter and edit data in the MEDICATION ROUTES file (#51.2). Medication routes

may be designated for use in all packages or for use only in the National Drug File package. If an

Outpatient Pharmacy expansion has been entered at the “OUTPATIENT EXPANSION” prompt,

the Outpatient Pharmacy expansion portion of the medication route will appear as part of the SIG

on the prescription label exactly as the Outpatient Pharmacy expansion was entered in

MEDICATION ROUTES file (#51.2). The IV FLAG field (#6) in the MEDICATION ROUTES

file (#51.2) is used to determine that the order can be processed through the IV portion of the

Inpatient Medications package. The PROMPT FOR INJ. SITE IN BCMA field (#8) in the

MEDICATION ROUTES file (#51.2) is used to send information to be displayed on the BCMA

Virtual Due List and Coversheet and to verify whether the user should be prompted for an

injection site. The DSPLY ON IVP/IVPB TAB IN BCMA? field (#9) in the MEDICATION

ROUTES file (#51.2) is used to send information to be displayed on the BCMA IVP/IVPB Tab

and Coversheet.

The Medication Route File Enter/Edit [PSS MEDICATION ROUTES EDIT] option allows the

user to enter an interpretation of the OUTPATIENT EXPANSION field (#4) in a language other

than English. PDM does not translate English terms into another language; instead, it allows the

user to enter a translation of a term. If a value has not been entered in the OTHER LANGUAGE

EXPANSION field (#4.1), PDM will default to the value entered in the OUTPATIENT

EXPANSION field (#4). If no values exist in the OUTPATIENT EXPANSION field (#4) and

OTHER LANGUAGE EXPANSION field (#4.1), the system will not display default values for


User Manual

those fields during CPRS or Outpatient Pharmacy prescription order entry processing. However,

when building the SIG, Outpatient Pharmacy will default to the value the user input during order

entry. See Appendix G for a list of Spanish equivalents for some of the more common

medication routes.

The Medication Route File Enter/Edit [PSS MEDICATION ROUTES EDIT] option allows the

user to map/remap their Local Medication Routes that are marked for 'All Packages’ to an active

Standard Medication Route. This is the only option that allows a Standard Medication Route

mapping to be deleted. When dosage checks are performed, the software will use this mapping to

pass the equivalent FDB Route for the Local Medication Route that was specified in the

medication order for the drug to the interface. If the Local Medication Route is not mapped,

dosage checks will not be performed. A user will not be prompted to map to a Standard

Medication Route if the Local Medication Route is not marked for ‘All Packages.’

Example 1 demonstrates how to enter a new medication route. Note that if an entry has been

mapped to a Standard Medication Route, the option to remap is offered. If an entry has not been

mapped to a Standard Medication Route and the user bypasses the prompt without mapping, a

warning is displayed that dosing checks will not be performed.

Example 1: Enter Medication Route File

Select Pharmacy Data Management Option: medication routes Management

Select Medication Routes Management Option: med

1 Medication Route File Enter/Edit

2 Medication Route Mapping Report

3 Medication Route Mapping History Report

CHOOSE 1-3: 1 Medication Route File Enter/Edit

Select MEDICATION ROUTES NAME: SUBCUTANEOUS

1 SUBCUTANEOUS SC

2 SUBCUTANEOUS SQ

3 SUBCUTANEOUS EPIDURAL CAUDAL SC ED CAUD

4 SUBCUTANEOUS INTRA-ARTICULAR SC IA

5 SUBCUTANEOUS INTRADERMAL SC ID


CHOOSE 1-5: 1 SUBCUTANEOUS SC

NAME: SUBCUTANEOUS// <ENTER>

ABBREVIATION: SC// <ENTER>

PACKAGE USE: ALL PACKAGES// <ENTER>

OUTPATIENT EXPANSION: <ENTER>

OTHER LANGUAGE EXPANSION: <ENTER>

IV FLAG: <ENTER>

PROMPT FOR INJ. SITE IN BCMA: <ENTER>

DSPLY ON IVP/IVPB TAB IN BCMA?: <ENTER>

Already mapped to:

Stnd Route: 'SUBCUTANEOUS' FDB Route: 'SUBCUTANEOUS'

Do you want to remap to a different Standard Med Route? N// <ENTER>O

Mapping Remains Unchanged.

Select MEDICATION ROUTES NAME: DEEP IM

NAME: DEEP IM// <ENTER>

ABBREVIATION: <ENTER>

PACKAGE USE: All Packages

OUTPATIENT EXPANSION: <ENTER>

OTHER LANGUAGE EXPANSION: <ENTER>

IV FLAG: <ENTER>


User Manual

PROMPT FOR INJ. SITE IN BCMA: <ENTER>

DSPLY ON IVP/IVPB TAB IN BCMA?: <ENTER>

STANDARD MEDICATION ROUTE: <ENTER>

*** No dosing checks will be performed on orders containing this local

medication route until it is mapped to a standard medication route.***

Text can be entered to edit the existing entries for a medication route. Since no value exists in the

OTHER LANGUAGE EXPANSION database and the user did not enter a translation, the

OUTPATIENT EXPANSION value will print on the patient’s prescription label by default.

Example 2: Medication Route File Edit

Select MEDICATION ROUTES NAME: SUBLINGUAL SL

NAME: SUBLINGUAL// <Enter>

ABBREVIATION: SL// <Enter>

PACKAGE USE: ALL PACKAGES// <Enter>

OUTPATIENT EXPANSION: UNTIL DISSOLVED// UNDER THE TONGUE UNTIL DISSOLVED

OTHER LANGUAGE EXPANSION: <Enter>

IV FLAG: <Enter>

PROMPT FOR INJ. SITE IN BCMA: <Enter>

DSPLY ON IVP/IVPB TAB IN BCMA? <Enter>

STANDARD MEDICATION ROUTE: <ENTER>

If the text to be replaced is more than 29 characters, the “REPLACE” prompt will automatically

appear. Replacement text for shorter text entries may be entered after the double slashes. Some

files may be set up to refuse deletions, depending on the site’s File Manager setup.

Example 3: Medication Route File Deletions Not Allowed

Select MEDICATION ROUTES NAME: NEW INHALATION MED ROUTE EXAMPLE NIMRE

NAME: NEW INHALATION MED ROUTE EXAMPLE Replace @

'DELETE ACCESS' REQUIRED!!?? Required

NAME: NEW INHALATION MED ROUTE EXAMPLE Replace ... With <Enter>

Replace <Enter>

'DELETE ACCESS' REQUIRED!!?? Required

NAME: NEW INHALATION MED ROUTE EXAMPLE Replace <Enter>

ABBREVIATION: NIMRE// <Enter>

PACKAGE USE: NATIONAL DRUG FILE ONLY// <Enter>

OUTPATIENT EXPANSION: AS NEEDED// <Enter>

OTHER LANGUAGE EXPANSION: <Enter>

IV FLAG: <Enter>

PROMPT FOR INJ. SITE IN BCMA: <Enter>

DSPLY ON IVP/IVPB TAB IN BCMA? <Enter>

1.8.2 Medication Route Mapping Report [PSS MED ROUTE MAPPING REPORT]

The Medication Route Mapping Report [PSS MED ROUTE MAPPING REPORT] option displays

the mapping between the Local Medication Route, the Standard Medication Route and the FDB

Route for Medication Routes marked for ‘All Packages.’

The report can be limited to unmapped Local Medication Routes or can display all Local

Medication Routes (that are marked for ‘All Packages’).


User Manual

Totals are displayed at the end of the report for the number of all Local Medication Routes

marked for ‘All Packages’ and the number of unmapped Local Medication Routes if the user

chooses to display all Local Medication Routes. If only unmapped Local Medication Routes are

chosen, the total for the number of unmapped entries will be displayed.

The report is formatted for 132 column width and can be sent to the screen or printer.

Example 1: User selects all Local Medication Routes


This report will print Medication Route mapping information for Medication

Routes marked for All Packages in the PACKAGE USE (#3) Field of the MEDICATION

ROUTES (#51.2) File.


A ALL MEDICATION ROUTES

O ONLY UNMAPPED MEDICATION ROUTES

Enter 'A' for All Routes, 'O' for Only Unmapped Routes: O// ALL MEDICATION ROUTES



MEDICATION ROUTES MAPPING REPORT Page: 1

MEDICATION ROUTES (File 51.2) STANDARD ROUTE FDB ROUTE

OUTPATIENT EXPANSION

--------------------------------------------------------------------------------------

BY MOUTH ORAL ORAL

DENTAL DENTAL DENTAL

EPIDURAL EPIDURAL EPIDURAL

INTRA-URETHRAL URETHRAL INTRA-URETHRAL

ORAL

BY MOUTH

MEDICATION ROUTES MAPPING REPORT Page: 2

MEDICATION ROUTES (File 51.2) STANDARD ROUTE FDB ROUTE


--------------------------------------------------------------------------------------

TOTAL LOCAL MEDICATION ROUTES = 5

TOTAL UNMAPPED LOCAL MEDICATION ROUTES = 1

End of Report.

Example 2: User selects only unmapped Local Medication Routes


This report will print Medication Route mapping information for Medication

Routes marked for All Packages in the PACKAGE USE (#3) Field of the MEDICATION




User Manual

A ALL MEDICATION ROUTES

O ONLY UNMAPPED MEDICATION ROUTES

Enter 'A' for All Routes, 'O' for Only Unmapped Routes: O// <ENTER> NLY UNMAPPED MEDICATION

ROUTES



MEDICATION ROUTES

MAPPING EXCEPTION REPORT Page: 1

MEDICATION ROUTES (File 51.2)


--------------------------------------------------------------------------------------

BOTH EYES

THIS IS A TEST

G TUBE

ORAL (BY MOUTH)

BY MOUTH

SUBCUTANEOUS

MEDICATION ROUTES MAPPING EXCEPTION REPORT Page: 2

MEDICATION ROUTES (File 51.2)


--------------------------------------------------------------------------------------

TOTAL UNMAPPED MEDICATION ROUTES = 4

End of Report.

1.8.3 Medication Route Mapping History Report [PSS MED ROUTE MAPPING CHANGES]

The Medication Route Mapping History Report [PSS MED ROUTE MAPPING CHANGES] option

tracks all mapping changes between Local Medication Routes and Standard Medication Routes.

The report can be run for a single medication route or for all medication routes over a specified

time frame.

Example 1: User selects single medication route

Select Enhanced Order Checks Setup Menu Option: Medication Route Mapping History Report

This report displays changes made to the mapping of Medication Routes in the MEDICATION

ROUTES (#51.2) File to Medication Routes in the STANDARD MEDICATION ROUTES (#51.23) File.


S Single Med Route

A All Med Routes

Print report for a Single Med Route, or All Med Routes: S// <ENTER> ingle Med Route


User Manual

Select Med Route: BOTH EYES

1 BOTH EYES OU

2 BOTH EYES

CHOOSE 1-2: 1 BOTH EYES OU

Beginning Date: T-30 (APR 28, 2008)

Ending Date: T (MAY 28, 2008)


Medication Route mapping changes for BOTH EYES

made between APR 28, 2008 and MAY 28, 2008 PAGE: 1

-----------------------------------------------------------------------------

Medication Route: BOTH EYES

Date/Time: MAY 28, 2008@09:57:58

Edited By: PHARMACIST,ONE

Old Value: ORAL

New Value: OPHTHALMIC


Date/Time: MAY 28, 2008@12:12:59

Edited By: PHARMACIST,ONE

Old Value: OPHTHALMIC

New Value: <no new value>

End of Report

Example 2: User selects all medication routes

Select Enhanced Order Checks Setup Menu Option: Medication Route Mapping History Report

This report displays changes made to the mapping of Medication Routes in the

MEDICATION ROUTES (#51.2) File to Medication Routes in the STANDARD MEDICATION



S Single Med Route

A All Med Routes

Print report for a Single Med Route, or All Med Routes: S// All Med Routes

Beginning Date: T-365 (JAN 10,2007)

Ending Date: T (JAN 10,2008)


Medication Route mapping changes for ALL Medication Routes Page: 1

made between JAN 10,2007 and JAN 10,2008

-----------------------------------------------------------------------

Medication Route: BOTH EARS

Date/time: JAN 9,2008@15:18

Edited by: PHARMACIST,ONE

Old Value: BUCCAL

New Value: OTIC


Date/time: NOV 30,2007@13:01:20

Edited by: PHARMACIST,TWO

Old Value: ORAL

New Value: OPHTHALMIC

This depicts a remapping from ‘ORAL’ to ‘OPHTHALMIC”

This depicts a deletion of a Standard Medication Route mapping.

This depicts a remapping from ‘ORAL’ to ‘OPHTHALMIC”


User Manual

Medication Route: INTRADERMAL

Date/time: DEC 19,2007@14:43:49

Edited by: AUTOMAPPED

Old Value: <no previous value>

New Value: INTRADERMAL

Medication Route: INTRAMUSCULAR

Date/time: JAN 9,2008@15:23:20

Edited by: PHARMACIST,ONE

Old Value: EPIDURAL

New Value: <no new value>

End Of Report

1.8.4 Request Change to Standard Medication Route [PSS MEDICATION ROUTE REQUEST]

The Request Change to Standard Medication Route [PSS MEDICATION ROUTE REQUEST]

option was provided for users to request additions or changes to the STANDARD

MEDICATION ROUTES file (#51.23). PSS*1*147 changes this option to now refer the

requestor to a web site to make the request.

A list of all Standard Medication Routes and corresponding FDB Route mapping initially

released with the PRE V.0.5 Pre-Release patch can be found in Appendix A of the Pharmacy

Reengineering (PRE) Version 0.5 Pre-Release Implementation Guide. Since then, there have

been additions pushed out by the New Term Rapid Turnaround (NTRT) process. For a complete

listing use FileMan to print the NAME field (#.01) and FIRST DATABANK MED ROUTE field

(#1) from the STANDARD MEDICATION ROUTES file (#51.23)

Example 1: Request Change to Standard Medication Route

Select Pharmacy Data Management Option: Request Change To Standard Medication Route

Standard Medication Route requests must now be made at the following website:

https://vaww.vashare.vha.va.gov/sites/ntrt/SitePages/Home.aspx


Standard Medication Routes File Update Notifications

Updates to the Standard Medication Route File are made by the New Term Rapid Turnaround

(NTRT) process. Patch PSS*1*147 provides MailMan notifications to the mail group PSS

ORDER CHECKS when changes occur. The following changes will generate a notification:

• Inactivation of a standard medication route

• Reactivation of a standard medication route

• Addition of a new standard medication route

• Change (add/delete/modify) to a FDB medication route mapping

• Change (add/delete/modify) to a replacement route for a standard medication route

This depicts a Local Medication Route which was automapped during the post init.

https://vaww.vashare.vha.va.gov/sites/ntrt/SitePages/Home.aspx


User Manual

Changes to a standard medication route that can result in an unmapping of a local medication

route are:

• Inactivation of a standard medication route

• Change (add/delete/modify) to an FDB Medication Route Mapping

If a local medication route that is marked for ‘All Packages’ is unmapped, the software will

attempt to do an automatic remapping to an active standard medication route. If the unmapping

occurred due to an inactivation of the standard medication route and a replacement route is

provided, the local medication route will be remapped to the new standard replacement route. If

no replacement route was provided in the update, a defined set of business rules will be used to

attempt an automatic remapping to another standard medication route.

The MailMan message will include the reason for notification, what was updated and will also

include any automatic mapping activities that occurred from the local Medication Routes file to

the Standard Medication Routes file.

Example 1: Addition of New Standard Medication Route

Subj: Standard Medication Route File Update [#136380] 08/21/09@09:58 64 lines

From: STANDARD MEDICATION ROUTE FILE PROCESSOR In 'IN' basket. Page 1 *New*

-------------------------------------------------------------------------------

The following entries have been added to the Standard Medication Routes

(#51.23) File:

ENTERAL

FDB Route: ORAL

The following entries have been inactivated in the Standard Medication

Routes (#51.23) File:

(None)

The following entries have been reactivated in the Standard Medication


(None)

The following entries in the Medication Routes (#51.2) File have been

mapped/remapped to a Standard Medication Route (#51.23) File entry.

G-TUBE

Previous Standard Route: ORAL

New Standard Route: ENTERAL

PLEASE REVIEW, MAY REQUIRE YOUR ATTENTION!


unmapped from a Standard Medication Route (#51.23) File entry.

(None)

The following entries in the Standard Medication Routes (#51.23) File have had

changes to the associated First DataBank Med Route and/or Replacement Term.

(None)

The following entries in the Medication Routes (#51.2) File were to be

mapped/remapped to a Standard Medication Route (#51.23) File entry, but

could not occur because the Medication Route (#51.2) File entry was locked.


User Manual

J-TUBE

Current Standard Route: ORAL

Recommend mapping to Standard Route: ENTERAL


unmapped from a Standard Medication Route (#51.23) File entry, but


(None)

Enter message action (in IN basket): Ignore //

Example 2: Inactivation of Standard Medication Routes; one with a Replacement Route and the other

without



-------------------------------------------------------------------------------


(#51.23) File:

INTRA-URETHRAL

FDB Route: INTRA-URETHRAL



URETHRAL


Replacement Term: INTRA-URETHRAL

Replacement Term FDB Route: INTRA-URETHRAL

INTRAVITREAL

FDB Route: INTRAVITREAL

Replacement Term: (None)

Replacement Term FDB Route: (None)



(None)



URETHRAL

Previous Standard Route: URETHRAL

New Standard Route: INTRA-URETHRAL




INTRAVITREAL

Previous Standard Route: INTRAVITREAL

New Standard Route: (None)



(None)




(None)


User Manual




(None)

Example 3: Remapping and Unmapping could not occur due to locked file



-------------------------------------------------------------------------------


(#51.23) File:

INTRA-URETHRAL




URETHRAL


Replacement Term: INTRA-URETHRAL

Replacement Term FDB Route: INTRA-URETHRAL

INTRAVITREAL

FDB Route: INTRAVITREAL

Replacement Term: (None)

Replacement Term FDB Route: (None)



(None)



(None)




(None)



(None)




URETHRAL

Current Standard Route: URETHRAL

Recommend mapping to Standard Route: INTRA-URETHRAL




INTRAVITREAL

Current Standard Route: INTRAVITREAL

New Standard Route: <delete mapping>



User Manual

Example 4: Reactivated Standard Medication Route



-------------------------------------------------------------------------------


(#51.23) File:

(None)



(None)



INTRADUCTAL

FDB Route: INTRADUCTAL



(None)




(None)



INTRADUCTAL

Replacement Term: <deleted>




(None)




(None)


1.8.5 Default Med Route for OI Report [PSS DEF MED ROUTE OI RPT]

The Default Med Route for OI Report [PSS DEF MED ROUTE OI RPT] option is listed on the

Medication Routes Management [PSS MEDICATION ROUTES MGMT] menu. This report can

be used to help identify the current default medication routes for the orderable items. The

following is an example of the report.


User Manual

• Patch PSS*1*153 added the ability to include printing the POSSIBLE MED ROUTES

multiple (#11) of the PHARMACY ORDERABLE ITEM file (#50.7). If the DEFAULT

MED ROUTE field (#.06) is populated then that value will be returned as the default

value. If the DEFAULT MED ROUTE field (#.06) is not populated and the POSSIBLE

MED ROUTES multiple (#11) is populated with a single entry and the USE DOSAGE

FORM MED ROUTE LIST field (#10) is set to “NO,” the single entry will be returned as

the default value. If the DEFAULT MED ROUTE field (#.06) is not populated and the

POSSIBLE MED ROUTES multiple (#11) is populated with more than one entry and the

USE DOSAGE FORM MED ROUTE LIST field (#10) is set to “NO,” no value will be

returned as the default value. The med routes selection list in CPRS will be populated

with all the medication routes associated with the orderable item’s dosage form if the

USE DOSAGE FORM MED ROUTE LIST field (#10) is set to "YES," otherwise it will

be populated from the POSSIBLE MED ROUTES multiple (#11). These conditions are

shown in the following table and examples are provided.

DEFAULT MED

ROUTE FIELD

POPULATED?

POSSIBLE MED

ROUTES FIELD

USE DOSAGE

FORM MED

ROUTE LIST

VALUE RETURNED – MED ROUTES

SELECTION IN CPRS

Y N N DEFAULT MED ROUTE field (#.06)

value

N Single Entry N Single Entry

N More Than One Entry N All med routes listed in the POSSIBLE

MED ROUTES multiple (#11)

N N Y All medication routes associated with

orderable item’s dosage form

Example 1: Default Med Route for Orderable Item Report [PSS DEF MED ROUTE OI RPT] Option

DEFAULT MED ROUTE FOR ORDERABLE ITEM REPORT JUN 17,2009 PAGE 1

OI NAME DOSAGE FORM ASSOCIATED ROUTES DEFAULT ROUTE POSSIBLE MED ROUTES DRUG

-------------------------------------------------------------------------------------------------

IBERET LIQUID ORAL (BY MOUTH) IBERET-500 ORAL

IBUPROFEN TAB ORAL (BY MOUTH) IBUPROFEN 600MG

IDOXURIDINE OINT,OPH RIGHT EYE

LEFT EYE

BOTH EYES IDOXURIDINE 0.5%

IMIPRAMINE TAB ORAL (BY MOUTH) IMIPRAMINE 25MG

IMIPRAMINE 50MG

INDOCYANINE INJ,SOLN INTRAMUSCULAR

INTRAVENOUS INTRAVENOUS INDOCYANINE 25MG

INSULIN INJ INTRAMUSCULAR

INTRAVENOUS

ORAL

SUBCUTANEOUS INTRAVENOUS INSULIN LENTE

INSULIN NPH

1.9 Orderable Item Management [PSS ORDERABLE ITEM MANAGEMENT]

The Orderable Item Management sub-menu provides an option through which the Pharmacy

Orderable Items are maintained.


User Manual

1.9.1 Edit Orderable Items [PSS EDIT ORDERABLE ITEMS]

The Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] option allows the user to enter and

edit data in the PHARMACY ORDERABLE ITEM file (#50.7). If a Pharmacy Orderable Item

Drug Text Entry is identified at the “OI-DRUG-TEXT” prompt, it will be viewable during

medication order entry processes through CPRS, Outpatient Pharmacy, and Inpatient

Medications. Pharmacy Orderable Item defaults can be entered for selected fields. These defaults

will be displayed to the user during the medication order entry processes for all applications

through which medication orders can be entered.

The Edit Orderable Items [PSS EDIT ORDERABLE ITEMS] option allows the user to enter a

default medication route and med route selection list.

The default medication route for CPRS will be derived from the DEFAULT MED ROUTE field

(#.06) of the PHARMACY ORDERABLE ITEM file (#50.7) if it is populated or from the

POSSIBLE MED ROUTES multiple (#50.711) of the PHARMACY ORDERABLE ITEM file

(#50.7) if it is populated with a single entry and the USE DOSAGE FORM MED ROUTE LIST

field (#10) is set to "NO."

Additional med routes for selection in the drop-down list in CPRS will be derived from the

POSSIBLE MED ROUTES multiple (#50.711) if the USE DOSAGE FORM MED ROUTE

LIST field (#10) is set to "NO." Otherwise, the med routes associated with the orderable item's

dosage form, MED ROUTE FOR DOSAGE FORM multiple (#50.6061) of the DOSAGE

FORM file (#50.606) will be returned.


User Manual

The method of deriving the appropriate medication routes listed above will be for Inpatient

Medications unit dose orders, IV Fluids orders, and Outpatient Pharmacy orders entered via

CPRS orders dialog.

Additionally, a report is available to view all current default medication routes as well as all

possible med routes for the listed orderable items. See the section entitled Default Med Route

For OI Report [PSSDEF MED ROUTE OI RPT].

Example 1: Edit Orderable Items with USE DOSAGE FORM MED ROUTE LIST field (#10) set to “NO”

Select Orderable Item Management Option: Edit Orderable Items

Select PHARMACY ORDERABLE ITEM NAME: INSULIN INJ

Orderable Item -> INSULIN

Dosage Form -> INJ

List all Drugs/Additives/Solutions tied to this Orderable Item? YES// Y YES


Dosage Form -> INJ

Dispense Drugs:

---------------

INSULIN REGULAR U-100 INJ

Are you sure you want to edit this Orderable Item? NO//Y YES


INSULIN INJ

Orderable Item Name: INSULIN//




INACTIVE DATE:


DEFAULT MED ROUTE: SUBCUTANEOUS//


INTRAVENOUS

INTRAMUSCULAR





USE DOSAGE FORM MED ROUTE LIST: N NO

List of Possible Med Routes associated with the orderable item:

INTRAVENOUS

Select POSSIBLE MED ROUTES: ORAL

1 ORAL PO

2 ORAL (BY MOUTH) PO

3 ORAL INHALATION ORALINHL

4 ORAL INTRADERMAL PERIOSTEAL ORALID PER

5 ORAL INTRAMUSCULAR ORALIM


CHOOSE 1-5: 1 ORAL PO


User Manual

The selected entry does not match any of the dosage form med routes.

Are you adding 'ORAL' as a new POSSIBLE MED ROUTE? NO// YES

Select POSSIBLE MED ROUTES:

SCHEDULE TYPE:

SCHEDULE:



RESPIRATORY THERAPY DRUG?:




Select SYNONYM:

Example 2: Edit Orderable Items with USE DOSAGE FORM MED ROUTE LIST field (#10) set to “NO”

and there are no Default Med Route nor Possible Med Routes



Dosage Form -> INJ

List all Drugs/Additives/Solutions tied to this Orderable Item? YES// NO



INSULIN INJ





INACTIVE DATE:


DEFAULT MED ROUTE:


INTRAVENOUS

INTRAMUSCULAR

ORAL INTRAMUSCULAR







You have not selected ANY med routes to display during order entry. In

order to have med routes displayed during order entry, you must either

define a DEFAULT MED ROUTE and/or at least one POSSIBLE MED ROUTE, or

answer YES to the USE DOSAGE FORM MED ROUTE LIST prompt.

**WITH THE CURRENT SETTINGS, NO MED ROUTES WILL DISPLAY FOR SELECTION

DURING ORDER ENTRY FOR THIS ORDERABLE ITEM**

The current setting is usually only appropriate for supply items.

Continue with no med routes displaying for selection during order entry? NO// YE

S

SCHEDULE TYPE:

SCHEDULE:


User Manual






Select SYNONYM:

Example 3: Edit Orderable Items with USE DOSAGE FORM MED ROUTE LIST field (#10) set to “YES”



Dosage Form -> INJ

List all Drugs/Additives/Solutions tied to this Orderable Item? YES// Y YES


Dosage Form -> INJ

Dispense Drugs:

INSULIN REGULAR U-100 INJ

---------------



INSULIN INJ





INACTIVE DATE:




INTRAVENOUS

INTRAMUSCULAR





USE DOSAGE FORM MED ROUTE LIST: Y YES

SCHEDULE TYPE:

SCHEDULE:







Select SYNONYM:

If the orderable item being edited is matched to any dispense drugs that are in VA drug classes

IM100 through IM900, an additional prompt will appear to permit mapping for the orderable

item to an associated immunization file entry. This feature is introduced with the Immunizations

Documentation by BCMA application in patches PSS*1*141 and PSB*3*47.


User Manual

Example: Editing Immunization-Related Pharmacy Orderable Items

Select PHARMACY ORDERABLE ITEM NAME: INFLUENZA INFLUENZA INJ

Orderable Item -> INFLUENZA

Dosage Form -> INJ

List all Drugs/Additives/Solutions tied to this Orderable Item? YES// <Enter>

Orderable Item -> INFLUENZA

Dosage Form -> INJ

Dispense Drugs:

---------------

INFLUENZA VACCINE



INFLUENZA INJ

Orderable Item Name: INFLUENZA// <Enter>






DEFAULT MED ROUTE: <Enter>


INTRAVENOUS

INTRAMUSCULAR





USE DOSAGE FORM MED ROUTE LIST: NO// Y YES

SCHEDULE TYPE: <Enter>

SCHEDULE: <Enter>

HIGH RISK/HIGH ALERT: <Enter>

PROMPT FOR REMOVAL IN BCMA: <Enter>


PATIENT INSTRUCTIONS: <Enter>



ASSOCIATED IMMUNIZATION: INFLUENZA FLU,3 YRS INFLUENZA





the local Pharmacy Orderable Item File (#50.7).

To set the values for PROMPT FOR REMOVAL IN BCMA (Field #12) in the local

PHARMACY ORDERABLE ITEM File (#50.7) (i.e., using PSS EDIT ORDERABLE ITEMS),

complete the steps shown in the example below:

The PROMPT FOR REMOVAL IN BCMA Field (#12) provides the following qualifying codes:

Note: The ASSOCIATED

IMMUNIZATION field (#9) is only

presented when at least one of the

dispense drugs tied to the selected

orderable item is in a VA Drug Class in

the IM100 to IM900 range.

Immunizations are typically found in VA

Drug Classes IM100, IM105, IM109,

IM700 or IM900.


User Manual

Choose from:





a. NULL/0 = No Removal Required. Duration of Administration field does not display

when the Pharmacist is finishing the order. This is consistent with existing

functionality for tablets, capsules and other unit dose medications not requiring

removal.

b. 1 = Removal at Next Administration. Duration of Administration field does not

display when the Pharmacist is finishing the order. BCMA user will be prompted for

removal automatically at next administration.

c. 2 = Removal Period Optional Prior to Next Administration. The Pharmacist is

prompted for Duration of Administration when finishing the order; however, this field

is optional/not required to finish the order. If Duration of Administration is entered by

the Pharmacist finishing the order, the BCMA user will be prompted for removal when

the Duration of Administration has ended. If no Duration of Administration is entered,

BCMA user will be prompted for removal at next administration.

d. 3 = Removal Period Required Prior to Next Administration. The Pharmacist is

prompted for Duration of Administration, which is required to finish the order. BCMA

user will be prompted for removal after the Duration of Administration has ended.

Note: PSS*1*191 also added the HIGH RISK/HIGH ALERT prompt to this

option, which was inadvertently missed in patch PSS*1*172.

Example 5 (Modify Pharmacy Orderable Item File with Dosage Form Containing the Word “PATCH”):


User Manual



This option enables you to edit Orderable Item names, Formulary status,

drug text, Inactive Dates, and Synonyms.

Select PHARMACY ORDERABLE ITEM NAME: NITROGLYCERIN

1 NITROGLYCERIN CAP,SA

2 NITROGLYCERIN INJ,SOLN

3 NITROGLYCERIN OINT,TOP 08-17-15

4 NITROGLYCERIN PATCH

5 NITROGLYCERIN TAB,SUBLINGUAL


CHOOSE 1-5: 4 NITROGLYCERIN PATCH

Orderable Item -> NITROGLYCERIN

Dosage Form -> PATCH


Orderable Item -> NITROGLYCERIN

Dosage Form -> PATCH

Dispense Drugs:

---------------

NITROGLYCERIN 0.4MG/HR PATCH



NEWITEM2

Are you sure you want to edit this Orderable Item? NO// Y YES


NITROGLYCERIN PATCH

Orderable Item Name: NITROGLYCERIN//




INACTIVE DATE:


DEFAULT MED ROUTE: TRANSDERMAL//




User Manual






The following Med Routes will now be displayed during order entry:

TRANSDERMAL


SCHEDULE: Q24H//

HIGH RISK/HIGH ALERT: WITNESS REQUIRED IN BCMA-HIGH RISK/ALERT //

PROMPT FOR REMOVAL IN BCMA: Removal Period Required Prior to Next Administration // ?



Choose from:





// ??



This field will allow for the following values.

NULL/0 = No Removal Required. Duration of Administration field

does not display when Pharmacist is finishing the order. This is

consistent with existing functionality for tablets, capsules and

other unit dose medications not requiring removal.

1 = Removal at Next Administration. Duration of Administration

field does not display when pharmacist is finishing the order.

BCMA user will be prompted for removal automatically at next

administration.

2 = Removal Period Optional Prior to Next Administration.

Pharmacist is prompted for Duration of Administration when

finishing the order; however, this field is optional/not

required to finish the order. If Duration of Administration is

entered by the pharmacist finishing the order, the BCMA user

will be prompted for removal when the Duration of

Administration has ended. If no Duration of Administration is

entered, BCMA user will be prompted for removal at next

administration.

3 = Removal Period Required Prior to Next Administration.

Pharmacist is prompted for Duration of Administration, which is

required to finish the order. BCMA user will be prompted for

removal after the Duration of Administration has ended.

Choose from:





// 2 Removal Period Optional Prior to Next Administration






Select SYNONYM:

Select PHARMACY ORDERABLE ITEM NAME:


User Manual

Example 6 (Modify Pharmacy Orderable Item File with Dosage Form Not Containing the Word “PATCH”):


Select PHARMACY ORDERABLE ITEM NAME: ACETAMINOPHEN TAB

Orderable Item -> ACETAMINOPHEN

Dosage Form -> TAB


Orderable Item -> ACETAMINOPHEN

Dosage Form -> TAB

Dispense Drugs:

---------------

ACETAMINOPHEN 1000MG TABLET

ACETAMINOPHEN 325MG C.T.

ACETAMINOPHEN 325MG TABLET

ACETAMINPHEN 325MG CT

ACETAMINOPHEN (A)



ACETAMINOPHEN TAB

Orderable Item Name: ACETAMINOPHEN//




INACTIVE DATE:

DAY (nD) or DOSE (nL) LIMIT: 5D//

DEFAULT MED ROUTE: ORAL (BY MOUTH)//









ORAL (BY MOUTH)

SCHEDULE TYPE: FILL ON REQUEST//

SCHEDULE: Q8H//

HIGH RISK/HIGH ALERT: HIGH RISK/ALERT-NO WITNESS REQUIRED IN BCMA //

PROMPT FOR REMOVAL IN BCMA: 0// ?


Choose from:





PROMPT FOR REMOVAL IN BCMA: 0// ??


This field will allow for the following values.

NULL/0 = No Removal Required. Duration of Administration field

does not display when Pharmacist is finishing the order. This is

consistent with existing functionality for tablets, capsules and

other unit dose medications not requiring removal.


User Manual

1 = Removal at Next Administration. Duration of Administration

field does not display when pharmacist is finishing the order.

BCMA user will be prompted for removal automatically at next

administration.

2 = Removal Period Optional Prior to Next Administration.

Pharmacist is prompted for Duration of Administration when

finishing the order; however, this field is optional/not

required to finish the order. If Duration of Administration is

entered by the pharmacist finishing the order, the BCMA user

will be prompted for removal when the Duration of

Administration has ended. If no Duration of Administration is

entered, BCMA user will be prompted for removal at next

administration.

3 = Removal Period Required Prior to Next Administration.

Pharmacist is prompted for Duration of Administration, which is

required to finish the order. BCMA user will be prompted for

removal after the Duration of Administration has ended.

Choose from:





PROMPT FOR REMOVAL IN BCMA: 0// 0 No Removal Required


PATIENT INSTRUCTIONS: TAKE ONE TABLET EVERY 8 HOURS AS NEEDED FOR PAIN.

Replace




Select SYNONYM:

Select PHARMACY ORDERABLE ITEM NAME:

If the Dosage Form containing the word “PATCH” is associated with the orderable item and the

user attempts to enter a value of 0, the following message displays indicating the entry is not

valid:

Example (Message When Attempting to Enter 0 for Orderable Item Containing the Word “PATCH”):

PROMPT FOR REMOVAL IN BCMA: Removal Period Optional Prior to Next Administration

// 0


Choose from:





//

If the Dosage Form containing the word “PATCH” is associated with the orderable item and the

user attempts to delete an existing entry (i.e., using “@” command), the following message

displays indicating the entry is not valid:


User Manual

Example (Message When Attempting to Delete Removal When Dosage Form Contains the Word “PATCH”):


// @



Choose from:

..1 Removal at Next Administration


..3 Removal Period Required Prior to Next Administration


//

If the Dosage Form associated with the orderable item does NOT contain the word “PATCH”,

and the user attempts to enter a value of 1, 2 or 3, the following message displays requesting that

the user confirm their entry.

• If the user responds with No (the default), as for a medication that does not require

removal (e.g. tablet, capsule, etc.), the value they entered is not accepted, as in this

example:

Example (Message When Attempting to Enter Removal Value for Medication Not Requiring Removal):

PROMPT FOR REMOVAL IN BCMA: 1 Removal at Next Administration

The dosage form for this orderable item is not PATCH.

Are you sure you want to designate this medication as requiring removal? N// N

No Changes were recorded.

• If the user responds with Yes, as for a medication that requires removal that is not a

transdermal patch (e.g., Nitroglycerin ointment or paste), the value they entered is

accepted, as in this example:

Example 7 (Message When Attempting to Enter Removal Value for Medication That Is Not

Patch But Does Require Removal):

PROMPT FOR REMOVAL IN BCMA: 2 Removal Period Optional Prior to Next

Administration

The dosage form for this orderable item is not PATCH.

Are you sure you want to designate this medication as requiring removal? N// Y

YES

Upon installation of PSS*1*191, the new PROMPT FOR REMOVAL IN BCMA field initially

has a value of NULL for all orderable items (active or inactive), and a post-install routine sets the

PROMPT FOR REMOVAL IN BCMA field to a value of 1 for all orderable items with Dosage

Form containing the word “PATCH”.

Subsequent to the PSS*1*191 installation, site representatives such as the Pharmacy ADPACs

need to determine which orderable items should have the new PROMPT FOR REMOVAL IN

BCMA field set to a value of 2 or 3. A post-install report included in this patch produces output

that consists of a list of items from the Pharmacy Orderable Item File (#50.7) where the Dosage

Form associated with the orderable item is “PATCH” and the PROMPT FOR REMOVAL IN

BCMA field was set to 1. The output from this report is sent to VistA Email addresses for users

with the PSJU MGR and PSJI MGR keys. The report contains the type of information shown in

the example below:


User Manual

Example 1 (PSS*1*191 Post-Install Report):

Subj: PHARMACY ORDERABLE ITEM MANAGEMENT [#123456] 07/14/15@16:49 16 lines

From: LASTNAME,FIRSTNAME In 'IN' basket. Page 1

-------------------------------------------------------------------------------

The following Orderable Items have the Dosage Form Patch and

the Prompt for Removal in BCMA field was updated to a value

of 1 by Patch PSS*1*191

ORDERABLE ITEM INACTIVE DISPENSE DRUG

NAME - DOSAGE FORM DATE NAME IEN

------------------------------ ------------ ------------------------- ------

FENTANYL - PATCH NONE FENTANYL 12.5MCG/HR PATCH 10024

FENTANYL 25MCG/HR PATCH 10031



FENTANYL 25MG PATCH - PATCH 5/29/2015 FENTANYL 125MCG/HR PATC 10025

TESTOSTERONE - PATCH,BUCCAL NONE TESTOSTERONE 30MG PATCH,B 10066

Patch PSS*1*204 adds two new fields to the PHARMACY ORDERABLE ITEM (#50.7) file

which are INDICATIONS FOR USE (#13) and MOST COMMON INDICATION FOR USE

(#14). Both fields are editable via the Edit Orderable Items [PSS EDIT ORDERABLE ITEMS],

Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS], and

Drug Enter/Edit [PSS DRUG ENTER/EDIT] options. The INDICATIONS FOR USE field is a

multiple that contains all of the available indications for use for an orderable item. The MOST

COMMON INDICATION FOR USE field contains the most common indication for use for the

orderable item. It does not need to exist in the INDICATIONS FOR USE (#13) field. It displays

as the first choice in the list of indications when presented to the user. Entries in both fields must

be 3-40 characters in length.

Example 1 (PSS*1*204 new INDICATIONS FOR USE and MOST COMMON INDICATION FOR USE

fields): Select Orderable Item Management Option: Edit Orderable Items



Dosage Form -> INJ

List all Drugs/Additives/Solutions tied to this Orderable Item? YES// NO



INSULIN INJ




INACTIVE DATE:




INTRAVENOUS

INTRAMUSCULAR



User Manual




USE DOSAGE FORM MED ROUTE LIST: Y YES


INTRAMUSCULAR

SUBCUTANEOUS

INTRAVENOUS

SCHEDULE TYPE:

SCHEDULE:


PROMPT FOR REMOVAL IN BCMA:



MOST COMMON INDICATION FOR USE: INDICATION FOR USE (MOST COMMON)

Select INDICATIONS FOR USE: INDICATION FOR USE 1



Select INDICATIONS FOR USE: ?

Answer with INDICATIONS FOR USE

Choose from:

INDICATION FOR USE 1



You may enter a new INDICATIONS FOR USE, if you wish



Select SYNONYM:

Patch PSS*1*225 adds the RESPIRATORY THERAPY DRUG? field (#15) to the

PHARMACY ORDERABLE ITEM file (#50.7) to store the classification of drugs for use in

Respiratory Therapy. The patch modifies the Edit Orderable Items [PSS EDIT ORDERABLE

ITEMS] option to include a prompt for users to designate an orderable item as a Respiratory

Therapy Drug.

Medications marked as a Respiratory Therapy Drug will display on the Report for Respiratory

Therapy Medications in the Bar Code Medication Administration (BCMA) package. Refer to the

BCMA Pharmacy CHUI User Manual for more information on generating this report.

Example (PSS*1*225 new RESPIRATORY THERAPY DRUG? prompt):


Select PHARMACY ORDERABLE ITEM NAME: ASPIRIN

1 ASPIRIN SUPP,RTL

2 ASPIRIN TAB

3 ASPIRIN TAB,CHEWABLE

4 ASPIRIN TAB,EC

5 ASPIRIN (UD) TAB,EC N/F

Press <Enter> to see more, '^' to exit this list, OR

CHOOSE 1-5: 2 ASPIRIN TAB

Orderable Item -> ASPIRIN

Dosage Form -> TAB

Orderable Item -> ASPIRIN

Dosage Form -> TAB

Dispense Drugs:


User Manual

---------------

ASPIRIN 325MG TAB

ASPIRIN 325MG TAB U.D. JAN 23, 2004



ASPIRIN TAB

Orderable Item Name: ASPIRIN//




INACTIVE DATE:


DEFAULT MED ROUTE: ORAL (BY MOUTH)//


ORAL (BY MOUTH)








ORAL (BY MOUTH)

SCHEDULE TYPE:

SCHEDULE: ONCE DAILY//

HIGH RISK/HIGH ALERT:

PROMPT FOR REMOVAL IN BCMA: 0// No Removal Required

RESPIRATORY THERAPY DRUG?: ?

Enter Y if this item is a respiratory therapy drug; otherwise enter N.

Choose from:

Y YES

N NO



MOST COMMON INDICATION FOR USE: Y//


Select SYNONYM:

1.9.2 Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS]

The Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS]

option is used for maintaining the relationship between Dispense Drugs and Pharmacy Orderable

Items. Entries made at the Pharmacy Orderable Item prompts will be used by the Outpatient

Pharmacy, Inpatient Medications, and CPRS packages as defaults during the medication order

entry processes. If no entries are made at the “MED ROUTE” and “SCHEDULE TYPE”

prompts, the software will assume the defaults of PO (oral) and CONTINUOUS, respectively.

The Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS]

option allows the user to enter patient instructions in a language other than English. PDM does

not translate English terms into another language; instead, it allows the user to enter a translation


User Manual

of a term. If a value has not been entered in the OTHER LANGUAGE INSTRUCTIONS field

(#7.1), PDM will default to the value entered in the PATIENT INSTRUCTIONS field (#7). If

the PATIENT INSTRUCTIONS field (#7) does not contain data for the selected orderable item,

the system will not present default patient instructions to the user during CPRS or Outpatient

Pharmacy prescription order processing. However, when building the SIG, Outpatient Pharmacy

will default to the value the user input through backdoor Outpatient Pharmacy order entry.

Example: Dispense Drug/Orderable Item Maintenance [PSS MAINTAIN ORDERABLE ITEMS] Option

Select Orderable Item Management Option: Dispense Drug/Orderable Item Maintenance

This option enables you to match Dispense Drugs to an entry in the Pharmacy

Orderable Item file, or create a new Pharmacy Orderable Item entry for a

Dispense Drug.

DISPENSE DRUG: IBUPROFEN 800MG TAB MS102

IBUPROFEN 800MG TAB is already matched to

IBUPROFEN TAB

Do you want to match to a different Orderable Item? NO// YES

There are other Dispense Drugs with the same VA Generic Name and same Dose Form already

matched to orderable items. Choose a number to match, or enter

Disp. drug -> IBUPROFEN 800MG TAB

1 IBUPROFEN TAB

Choose number of Orderable Item to match, or '^' to enter a new one: 1

Matching IBUPROFEN 800MG TAB

to

IBUPROFEN TAB

Is this OK? YES// <Enter>

Match Complete!


IBUPROFEN TAB




DAY (nD) or DOSE (nL) LIMIT: 7D// <Enter>

MED ROUTE: <Enter>

SCHEDULE TYPE: PRN//<Enter>

SCHEDULE: BID// <Enter>



PATIENT INSTRUCTIONS: WF// <Enter>

OTHER LANGUAGE INSTRUCTIONS: CON ALIMENTO




IV solutions matched to an Orderable item will now be governed by the following rule (patch

PSS*1*189):

An Orderable Item can only have ONE IV solution with a specific volume when it is marked to

be used in the IV Order Dialog. When adding a new item to an Orderable item the volume for the


User Manual

new item must follow the above rule or an error message will display as shown in the example

below:

Example:

PRINT NAME: NACL 0.9%/KCL 40MEQ Replace

PRINT NAME {2}:

GENERIC DRUG: POTASSIUM CL 40MEQ/NACL 0.9% INJ,1000 ML// TN102

VOLUME: 1000 ML//

Select ELECTROLYTES:

Select SYNONYM: 0.9% SODIUM CHLORIDE 40MEQ//

DRUG INFORMATION:

No existing text

Edit? NO//

AVERAGE DRUG COST: .01//

INACTIVATION DATE:

USED IN IV FLUID ORDER ENTRY: NO// YES

The following IV Solution with the same volume is already linked to the

Orderable Item SODIUM CHLORIDE 0.9%

Dispense Drug: POTASSIUM CL 20MEQ/NACL 0.9% INJ,1000 ML

IV Solution: NACL 0.9%/KCL 20MEQ 1000 ML

Only one IV solution with a specific volume can be linked to an

Orderable Item when the IV Solution is marked to be used in the IV FLUID

ORDER ENTRY.

USED IN IV FLUID ORDER ENTRY: NO//

PREMIX:

Following the on-screen instructions of “Now Editing Orderable Item,” if the orderable item

being edited is matched to any dispense drugs that are in VA drug classes IM100 through IM900,

an additional prompt will appear to permit mapping of the orderable item to an associated

immunization file entry. This feature is introduced with the Immunizations Documentation by

BCMA application in patches PSS*1*141 and PSB*3*47. Example: Editing Immunization-Related Pharmacy Orderable Items




MED ROUTE: <Enter>

SCHEDULE TYPE: <Enter>

SCHEDULE: <Enter>



PATIENT INSTRUCTIONS: <Enter>

OTHER LANGUAGE INSTRUCTIONS: <Enter>



ASSOCIATED IMMUNIZATION: INFLUENZA FLU,3 YRS INFLUENZA


Note: The ASSOCIATED IMMUNIZATION field is only presented when at least one

of the dispense drugs tied to the selected orderable item is in a VA Drug Class in the

IM100 to IM900 range. Immunizations are typically found in VA Drug Classes IM100,

IM105, IM109, IM700, or IM900.


User Manual




the local Pharmacy Orderable Item File (#50.7). For more information, see section 1.9.1.

Patch PSS*1*191 also added the HIGH RISK/HIGH ALERT prompt to this option, which was

inadvertently missed in patch PSS*1*172.

Example 7: Prompt for HIGH RISK/HIGH ALERT added to Dispense Drug/Orderable Item Maintenance

option:


SCHEDULE: Q24H//

HIGH RISK/HIGH ALERT: HIGH RISK/ALERT-NO WITNESS REQUIRED IN BCMA



User Manual

1.9.3 Orderable Item/Dosages Report [PSS ORDERABLE ITEM DOSAGES]

The Orderable Item/Dosages Report [PSS ORDERABLE ITEM DOSAGES] option prints a

report that displays Inpatient Medication and Outpatient Pharmacy dosages for each Pharmacy

Orderable Item. These are the dosages that will display for selection through CPRS when an

Orderable Item is selected through CPRS at the time an Orderable Item is selected for a

medication order. Due to the length of this report, it must be queued to a printer.

This option prints a report, sorted by Pharmacy Orderable Item that displays Inpatient

Medication and Outpatient Pharmacy dosages for Pharmacy Orderable Items. These dosages will

display for selection through CPRS when an Orderable Item is selected for a medication order.

Along with each dosage that is displayed on the report, the name of the drug entry from the

DRUG file (#50) that provided the dosage is displayed.

Not every dosage from the DRUG file (#50) will display on this report. For example, if there are

duplicate Possible Dosages for a Pharmacy Orderable Item, and there are different Dispense

Units Per Dose, only the Possible Dosage with the lowest Dispense Units Per Dose will display

on the report. If there are package specific Possible Dosages and Local Possible Dosages for

drugs tied to the Pharmacy Orderable Item, only the Possible Dosages will display on the report

because Possible Dosages always override Local Possible Dosages.

In summary, this report will screen out Possible Dosages and Local Possible Dosages when

appropriate, so only the dosages selectable through CPRS will display on this report.

Additionally, the report will display in parenthesis the dosage, as it will appear on the Outpatient

Pharmacy prescription label, if the dosage is a Possible Dosage.

Example: Orderable Item Dosages Report [PSS ORDERABLE ITEM DOSAGES] Option

Select Orderable Item Management Option: ORDerable Item/Dosages Report


A ALL

S SELECT A RANGE

Print Report for (A)ll or (S)elect a Range: S// <Enter> ELECT A RANGE

There are entries in the Orderable Item file with leading numerics.

Print report for Orderable Items with leading numerics? N//<Enter> O

To see items beginning with the letter 'A', enter 'A', or whichever letter you

wish to see. To see items in a range, for example items starting with the

letters 'G', 'H', 'I' and 'J', enter in the format 'G-J'.

Select a Range: C

Report will be for items starting with the letter C,

and ending with items starting with the letter C.

Is this correct? Y// <Enter> ES

DEVICE: HOME// DECSERVER


User Manual

Dosage report for Orderable Items from C through C PAGE: 1

-----------------------------------------------------------------------------

CAFFEINE/ERGOTAMINE TAB

Inpatient Dosages:

1 TABLET CAFFEINE 100/ERGOTAMINE 1MG TAB

2 TABLETS CAFFEINE 100/ERGOTAMINE 1MG TAB

Outpatient Dosages:

1 TABLET CAFFEINE 100/ERGOTAMINE 1MG TAB

2 TABLETS CAFFEINE 100/ERGOTAMINE 1MG TAB

CALCITONIN INJ,SOLN

Inpatient Dosages:

200UNT/1ML CALCITONIN-SALMON 200 UNT/ML INJ

400UNT/2ML CALCITONIN-SALMON 200 UNT/ML INJ

Outpatient Dosages:

0.125ML (25 UNITS) CALCITONIN SALMON 200 UNT/ML INJ

1ML (200 UNITS) CALCITONIN SALMON 200 UNT/ML INJ



CALCITRIOL CAP,ORAL

Inpatient Dosages:

0.25MCG (1 CAPSULE) CALCITRIOL 0.25MCG CAP

0.5MCG (2 CAPSULES) CALCITRIOL 0.25MCG CAP

Outpatient Dosages:

0.25MCG (1 CAPSULE) CALCITRIOL 0.25MCG CAP

0.5MCG (2 CAPSULES) CALCITRIOL 0.25MCG CAP

CALCIUM INJ,CONC

Outpatient Dosages:

CALCIUM CHLORIDE 1GM/10ML INJ.

CALCIUM CARBONATE POWDER

Outpatient Dosages:

CALCIUM CARBONATE PWD

CALCIUM CARBONATE/SODIUM FLUORIDE CAP,ORAL

Outpatient Dosages:

1 CAPSULE FLORICAL CAPS

2 CAPSULES FLORICAL CAPS

CALCIUM CHLORIDE INJ,SOLN

Outpatient Dosages:

CALCIUM GLUCONATE 10% INJ

CALCIUM CHLORIDE INJ,CONC

Outpatient Dosages:

CALCIUM CHLORIDE 10% 10ML B.J.

CALCIUM GLUBIONATE SYRUP

Outpatient Dosages:

1 TEASPOONFUL NEO-CALGLUCON SYRUP (OZ)

2 TEASPOONFULS NEO-CALGLUCON SYRUP (OZ)

1 TABLESPOONFUL NEO-CALGLUCON SYRUP (OZ)

2 TABLESPOONFULS NEO-CALGLUCON SYRUP (OZ)

1 ML NEO-CALGLUCON SYRUP (OZ)

2 MLS NEO-CALGLUCON SYRUP (OZ)

CALCIUM LACTATE POWDER

Outpatient Dosages:

CALCIUM LACTATE POWDER USP

CAMPHOR LIQUID

Outpatient Dosages:

CAMPHOR SPIRITS 30ML

CANDIDA ALBICANS INJ

Inpatient Dosages:

0.1ML CANDIDA ALBICANS SKIN TEST

Outpatient Dosages:


User Manual

0.1ML CANDIDA ALBICANS SKIN TEST

CANNULA, NASAL DEVICE

Outpatient Dosages:

CANNULA, NASAL (HUDSON)

CAPTOPRIL TAB

Inpatient Dosages:

25MG CAPTOPRIL 25MG TABS




Outpatient Dosages:

25MG (1 TABLET) CAPTOPRIL 25MG TABS



200MG (2 TABLETS) CAPTOPRIL 100MG TABS

2500MG (50 TABLETS) CAPTOPRIL 50MG TAB

CARBACHOL SOLN,OPH

Inpatient Dosages:

1 DROP CARBACHOL 1.5% OPH SOLN

2 DROPS CARBACHOL 1.5% OPH SOLN

1 DROP CARBACHOL 3% OPH SOLN

2 DROPS CARBACHOL 3% OPH SOLN

Outpatient Dosages:

1 DROP CARBACHOL 1.5% OPH SOLN

2 DROPS CARBACHOL 1.5% OPH SOLN

1 DROP CARBACHOL 3% OPH SOLN

2 DROPS CARBACHOL 3% OPH SOLN

CARBAMAZEPINE TAB,ORAL 11/13/00

CARBENICILLIN TAB

Inpatient Dosages:

382MG CARBENICILLIN INDANYL NA 382MG TAB

764MG CARBENICILLIN INDANYL NA 382MG TAB

Outpatient Dosages:

382MG (1 TABLET) CARBENICILLIN INDANYL NA 382MG TAB

764MG (2 TABLETS) CARBENICILLIN INDANYL NA 382MG TAB

CARBIDOPA/LEVODOPA TAB

Inpatient Dosages:

1 TABLET CARBIDOPA 10/LEVODOPA 100MG TAB

2 TABLETS CARBIDOPA 10/LEVODOPA 100MG TAB



Outpatient Dosages:





CARMUSTINE INJ,SOLN

Inpatient Dosages:

100MG/1VIAL CARMUSTINE 100MG/VIAL INJ

200MG/2VIAL CARMUSTINE 100MG/VIAL INJ

Outpatient Dosages:

CARMUSTINE COMB.PK

CARMUSTINE 100MG/VIAL INJ

CAROTENE,BETA CAP,ORAL

Inpatient Dosages:

30MG BETA-CAROTENE 30MG CAP

60MG BETA-CAROTENE 30MG CAP

Outpatient Dosages:

30MG (1 CAPSULE) BETA-CAROTENE 30MG CAP

60MG (2 CAPSULES) BETA-CAROTENE 30MG CAP

:

:


User Manual

End of Report.


Select Orderable Item Management Option:

1.9.4 Patient Instructions Report [PSS INSTRUCTIONS/ITEMS REPORT]

The Patient Instructions Report [PSS INSTRUCTIONS/ITEMS REPORT] option prints a report

that displays Pharmacy Orderable Items, along with the expanded Patient Instructions for each

Pharmacy Orderable Item. These Patient Instructions are used as default values for Outpatient

Pharmacy orders entered through CPRS and Outpatient Pharmacy. This report can be printed to

display all Pharmacy Orderable Items or only Orderable Items with associated Patient

Instructions.

Example: Patient Instructions Report [PSS INSTRUCTIONS/ITEMS REPORT] Option

Select Pharmacy Data Management Option: OR

1 Orderable Item Management

2 Orderable Item Report

CHOOSE 1-2: 1 Orderable Item Management

Select Orderable Item Management Option: PAtient Instructions Re

port


A ALL

S SELECT A RANGE


There are entries in the Orderable Item file with leading numerics.

Print report for Orderable Items with leading numerics? N// <Enter> O

To see items beginning with the letter 'A', enter 'A', or whichever letter you

wish to see. To see items in a range, for example items starting with the


Select a Range: N

Report will be for items starting with the letter N,

and ending with items starting with the letter N.

Is this correct? Y//<Enter> ES

Should report only include Orderable Items with Patient Instructions? Y// <Enter> ES

DEVICE: HOME// TELNET DEVICE

Instructions report for items from N through N PAGE: 1

-----------------------------------------------------------------------------

NAPROXEN TAB

WITH FOOD

NITROGLYCERIN TAB,SUBLINGUAL

FOR CHEST PAIN-CALL PHYSICIAN IF NO RELIEF AFTER 3 DOSES

End of Report.


User Manual


Select Orderable Item Management Option:

1.9.5 Orderable Item Report [PSS ORDERABLE ITEM REPORT]

The Orderable Item Report [PSS ORDERABLE ITEM REPORT] option lists items from the

PHARMACY ORDERABLE ITEM file (#50.7), along with the associated Dispense Drugs. Due

to the length of this report it must be queued to a printer.

Example: Orderable Item Report [PSS ORDERABLE ITEM REPORT] Option

Select Pharmacy Data Management Option: ORDER

1 Orderable Item Management

2 Orderable Item Report

CHOOSE 1-2: 2 Orderable Item Report


M Drugs that are matched

N Drugs that are not matched

Enter M to see all the IV Solutions, IV Additives, and Dispense Drugs that

are matched to an Orderable Item. Enter N to see all IV Additives, IV

Solutions, and Dispense Drugs that are not matched to an Orderable Item.

Enter M or N: M Drugs that are matched

** WARNING ** THIS REPORT MAY BE VERY LONG ** WARNING **

Due to the length of this report, and to avoid tying up a terminal for a long

time, this report must be QUEUED to a printer!

This report must be QUEUED to a printer!

DEVICE: Printer 1

Requested Start Time: NOW// (JUL 18, 2001@13:59:39)

ORDERABLE ITEM - DISPENSE DRUG (MATCHED REPORT) PAGE: 1

------------------------------------------------------------------------------

(853) A-FIL CREAM,TOP

(1215) Dispense Drug -> A-FIL CREAM 45GM

------------------------------------------------------------------------------

(2798) ABACAVIR(ZIAGEN) TAB

(4508) Dispense Drug -> ABACAVIR (ZIAGEN) 300MG TAB UD

------------------------------------------------------------------------------

(2229) ABCIXIMAB INJ,SOLN

(3912) Dispense Drug -> ABCIXIMAB (REOPRO) 2MG/ML INJ

------------------------------------------------------------------------------

(1833) ABDOMINAL PAD

(25) Dispense Drug -> PAD,ABDOMINAL 7.5 X 8 STERILE

(2577) Dispense Drug -> PADS ABDOMINAL 5X9

(3276) Dispense Drug -> COTTON WADDING

------------------------------------------------------------------------------

(1944) ABDOMINAL BINDER BELT

(2743) Dispense Drug -> ABDOMINAL BINDER

------------------------------------------------------------------------------

(2101) ACARBOSE TAB

(3764) Dispense Drug -> ACARBOSE (PRECOSE) 50MG TAB

(3765) Dispense Drug -> ACARBOSE (PRECOSE) 25MG TAB

------------------------------------------------------------------------------

(1) ACEBUTOLOL CAP,ORAL

(577) Dispense Drug -> ACEBUTOLOL 200MG CAP

(3335) Dispense Drug -> ACEBUTOLOL 400MG CAP


User Manual

------------------------------------------------------------------------------

(1629) ACETAMINOPHEN TAB

(263) Dispense Drug -> ACETAMINOPHEN 325MG TAB

(2730) Dispense Drug -> ACETAMINOPHEN 325MG TAB UD

(4429) Dispense Drug -> ZTEST

------------------------------------------------------------------------------

(2663) ACETAMINOPHEN ELIXIR

(2564) Dispense Drug -> ACETAMINOPHEN LIQ 650MG/20.3ML U.D. CUP

------------------------------------------------------------------------------

(1681) ACETAMINOPHEN LIQUID,ORAL

(494) Dispense Drug -> ACETAMINOPHEN LIQ 160MG/5ML 4OZ

(1723) Dispense Drug -> ACETAMINOPHEN 500MG/15CC ELIXIR

------------------------------------------------------------------------------

(4) ACETAMINOPHEN SUPP,RTL

(264) Dispense Drug -> ACETAMINOPHEN 650MG RTL SUPP

------------------------------------------------------------------------------

(2117) ACETAMINOPHEN/BUTALBITAL/CAFFEINE CAP,ORAL

(3295) Dispense Drug -> APAP 325MG/BUTALBITAL 50MG/CAFN 40MG CAP

------------------------------------------------------------------------------

(6) ACETAMINOPHEN/CHLORZOXAZONE TAB

(1808) Dispense Drug -> CHLORZOXAZONE & ACETAMINOPHEN TAB

------------------------------------------------------------------------------

(8) ACETAMINOPHEN/CODEINE TAB

(341) Dispense Drug -> ACETAMINOPHEN WITH CODEINE 60MG

(342) Dispense Drug -> ACETAMINOPHEN WITH CODEINE 30MG TAB

(343) Dispense Drug -> ACETAMINOPHEN WITH CODEINE 15MG TAB

(2029) Dispense Drug -> ACETAMIN W/CODEINE 30MG(TYLENOL#3)TAB UD

------------------------------------------------------------------------------

(7) ACETAMINOPHEN/CODEINE ELIXIR

(228) Dispense Drug -> ACETAMINOPHEN AND CODEINE ELIXIR (ML)

(401) Dispense Drug -> ACETAMIN W/CODEINE 30MG/12.5ML LIQ UD

------------------------------------------------------------------------------

(9) ACETAMINOPHEN/HYDROCODONE CAP,ORAL

(1728) Dispense Drug -> HYDROCODONE/ACETAMINOPHEN (LORCET-HD)

------------------------------------------------------------------------------

(10) ACETAMINOPHEN/HYDROCODONE TAB

(3293) Dispense Drug -> HYDROCODONE 5MG/ACETAMINOPHEN 500MG TAB

(4099) Dispense Drug -> HYDROCODONE 7.5MG/ACETAMINOPHEN 750MG TB

------------------------------------------------------------------------------

(1762) ACETAMINOPHEN/HYDROCODONE LIQUID,ORAL

(1572) Dispense Drug -> HYDROCODONE/ACETAMIN 2.5MG/167MG/5ML LIQ

------------------------------------------------------------------------------

(2730) ACETAMINOPHEN/OXYCODONE CAP,ORAL

(344) Dispense Drug -> ACETAMINOPHEN & OXYCODONE (TYLOX) CAP

------------------------------------------------------------------------------

(2614) ACETAMINOPHEN/OXYCODONE TAB

(1452) Dispense Drug -> OXYCODONE /ACETAMINOPHEN (PERCOCET) TAB

(1510) Dispense Drug -> ACETAMIN W/OXYCODONE 5MG(PERCOCET)TAB UD

------------------------------------------------------------------------------

(12) ACETAZOLAMIDE CAP,SA

(639) Dispense Drug -> ACETAZOLAMIDE 500MG T.R.C.

(2599) Dispense Drug -> ACETAZOLAMIDE 500MG CAP,SA

------------------------------------------------------------------------------

(13) ACETAZOLAMIDE INJ

(640) Dispense Drug -> ACETAZOLAMIDE NA 500MG/VIL INJ

------------------------------------------------------------------------------

(14) ACETAZOLAMIDE TAB

(638) Dispense Drug -> ACETAZOLAMIDE 250MG TAB

------------------------------------------------------------------------------

(2156) ACETIC ACID LIQUID

(2506) Dispense Drug -> DOUCHE VAGINAL (VINEGAR)

(4184) Dispense Drug -> ACETIC ACID 5%

------------------------------------------------------------------------------

(18) ACETIC ACID SOLN,OTIC

(1665) Dispense Drug -> ZZACETIC ACID 2% (VOSOL) SOLN,OTIC 30ML

(4113) Dispense Drug -> ACETIC ACID 2% (VOSOL) OTIC SOLN (15)

------------------------------------------------------------------------------

(17) ACETIC ACID SOLN,IRRG

(675) Dispense Drug -> ACETIC ACID 0.25% SOLN,IRRG

(4108) Dispense Drug -> ACETIC ACID 0.25% IRRG SOLN

------------------------------------------------------------------------------


User Manual

(2201) ACETIC ACID,GLACIAL LIQUID

(1185) Dispense Drug -> ACETIC ACID,GLACIAL LIQUID

------------------------------------------------------------------------------

(15) ACETIC ACID/ALUMINUM ACETATE SOLN,OTIC

(1193) Dispense Drug -> DOMEBORO SOLN,OTIC

------------------------------------------------------------------------------

(16) ACETIC ACID/HYDROCORTISONE SOLN,OTIC

(1881) Dispense Drug -> ZZACETIC ACID/HYDROCORT (VOSOL HC) OTIC

(4112) Dispense Drug -> ACETIC ACID/HYDROCORT(VOSOL HC) OTIC(10)

------------------------------------------------------------------------------

(19) ACETOHEXAMIDE TAB

(951) Dispense Drug -> ACETOHEXAMIDE 250MG TAB

(952) Dispense Drug -> ACETOHEXAMIDE 500MG TAB

------------------------------------------------------------------------------

(20) ACETONE LIQUID

(1292) Dispense Drug -> ACETONE 1PT

------------------------------------------------------------------------------

(21) ACETOPHENAZINE MALEATE TAB

(383) Dispense Drug -> ACETOPHENAZINE MALEATE 20MG TAB

------------------------------------------------------------------------------

(22) ACETYLCHOLINE CHLORIDE SOLN,OPH

(749) Dispense Drug -> ACETYLCHOLINE CL 1% SOLN,OPH

(2118) ACETYLCYSTEINE 10% SOLN,OPH

(225) Dispense Drug -> ACETYLCYSTEINE 10% OPH DROPS 10ML

------------------------------------------------------------------------------

(2119) ACETYLCYSTEINE 10% SOLN,INHL

(173) Dispense Drug -> ACETYLCYSTEINE 10% INHL SOLN (10)

------------------------------------------------------------------------------

(23) ACETYLCYSTEINE 20% SOLN,INHL


(1634) Dispense Drug -> ZZACETYLCYSTEINE 20% SOLN 10ML VI


------------------------------------------------------------------------------

(2443) ACITRETIN CAP,ORAL

(4193) Dispense Drug -> ACITRETIN 25MG CAP

(4317) Dispense Drug -> ACITRETIN 10MG CAP

------------------------------------------------------------------------------

(1881) ACRIVASTINE/PSEUDOEPHEDRINE CAP,ORAL

(3490) Dispense Drug -> ACRIVASTINE 8/PSEUDOEPHEDRINE 60MG CAP

------------------------------------------------------------------------------

(2631) ACTIVE LIFE (0227-71) POUCH

(4254) Dispense Drug -> POUCH,OSTOMY,ACTIVE LIFE C#0227-71

------------------------------------------------------------------------------

(24) ACYCLOVIR INJ

(3045) Dispense Drug -> ACYCLOVIR (ZOVIRAX) 500MG INJ

(43) Additive -> ACYCLOVIR (ZOVIRAX)

------------------------------------------------------------------------------

(2522) ACYCLOVIR TAB

(2154) Dispense Drug -> ACYCLOVIR (ZOVIRAX) 800MG TAB

(4308) Dispense Drug -> ACYCLOVIR 800MG UD TAB

------------------------------------------------------------------------------

(28) ACYCLOVIR OINT,TOP

(2443) Dispense Drug -> ZZACYCLOVIR 5% (ZOVIRAX) OINT,TOP 15GM

(4221) Dispense Drug -> ACYCLOVIR 5% OINTMENT (15)

------------------------------------------------------------------------------

(26) ACYCLOVIR CAP,ORAL

(2600) Dispense Drug -> ACYCLOVIR (ZOVIRAX) 200MG CAPS

------------------------------------------------------------------------------

(25) ACYCLOVIR SUSP

(3522) Dispense Drug -> ACYCLOVIR (ZOVIRAX) SUSP 800MG/20ML

------------------------------------------------------------------------------

(29) ADAPETTES SOLN,OPH

(2271) Dispense Drug -> ADAPETTES (15ML)

------------------------------------------------------------------------------

(1945) ADAPTER MISCELLANEOUS

(2676) Dispense Drug -> ADAPTER FOR URINE BAG

------------------------------------------------------------------------------

(2017) ADAPTER,JEJUNOSTOMY ADAPTER


User Manual

1.9.6 Reports for Medications Requiring Removal (MRR)

Reports have been created that can be run from the Pharmacy Data Management [PSS MGR]

menu which will allow the user to generate a report that lists patients with orders that have

Medications Requiring Removal (MRRs) that were Finished and Active prior to the install of

patch PSJ*5*315, a report identifying all Orderable Items that are MRRs, and a report

identifying all Orderable Items that are marked as Medications Requiring or Recommending

Witness for Administration.

1. Orders for MRRs with Removal Properties

2. Orderable Items that Require Removal

3. Orderable Items Report for High Risk/High Alert

Orders for MRRs with Removal Properties

The Orders for MRRs with Removal Properties report shows active orders that contain Orderable

Items that have the new “Prompt for Removal in BCMA” flag value set to 1, 2, or 3:




The MRR diagnostic utility report Orders for MRRs with Removal Properties needs to be run

prior to and after the Pharmacy Inpatient PSJ*5*315 patch has been installed. The orders that

show up on this list need to be re-entered as new orders or they will not function correctly with

the new removal features and full functionality introduced in this patch, however, they will not

cause errors.

Example: Orders for MRRs with Removal Properties [PSS MRR ORDERS DIAGNOSTIC RPT] Option


User Manual

Orderable Items that Require Removal Report

The Orderable Items that Require Removal report shows which Orderable Items have the

“Prompt for Removal in BCMA” Medications Requiring Removal flag set to a value of 1, 2, or

3:




This report helps the users check that the appropriate Orderable Items have been designated as

Medications Requiring Removal.

Users can access the Orderable Items that Require Removal report from the PSS MGR

Pharmacy Data Management -> Orderable Item Management menu options.

This report will also:

• Allow the user to select ALL “Prompt for Removal in BCMA” flag values of 1, 2,

and 3 (default) or specific values of 1, 2, or 3.

• Display help text when a single question mark “?’ is entered at the report parameter

prompt “Print Report for (A)ll or Specific MRR Flag values(1,2,3): (A/1/2/3): A//?”

• Contain Orderable Item Name, Dosage Form, Orderable Item Inactive Date,

Medications Requiring Removal flag value, Dispense Drug Name and Dispense Drug

Inactive Date.

Example: Orderable Items that Require Removal [PSS MRR ODERABLE ITEMS RPT] Option

Orderable Items Report on Medications Requiring Removal (MRR) Prompt for Removal in BCMA Value

Page 1

ORDERABLE ITEM OI INACTIVE MRR DISPENSE DRUG (DD) DD INACTIVE

NAME - DOSAGE FORM DATE VAL NAME DATE

------------------------------ ------------ --- ------------------------------ -----------

BUPRENORPHINE - PATCH 1 BUPRENORPHINE 10MCG/HR PATCH

CLONIDINE - PATCH 1 CLONIDINE 0.1MG/24HR PATCH

CLONIDINE 0.2MG/24HR PATCH

CLONIDINE 0.3MG/24HR PATCH

ZZ-CLONIDINE PATCH .1MG *UD*(C 7/11/1998



COMBIPATCH - PATCH 2 COMBIPATCH 50/140MCG (8X8)

COMBIPATCH 50/250MCG

DICLOFENAC - PATCH 1 DICLOFENAC EPOLAMINE 1.3% PATC

ESTRADIOL - PATCH 2/27/2012 1 ZZ-ESTRADIOL 37.5MCG/DAY(VIVEL 2/27/2012

ESTRADIOL CLIMARA - PATCH 2 ESTRADIOL 0.05MG/DAY (CLIMARA)

ESTRADIOL 0.025MG/DAY (CLIMARA

ESTRADIOL 0.075MG/DAY (CLIMARA

ESTRADIOL 0.0375MG/DAY (CLIMAR

ESTRADIOL VIVELLE-DOT BRAND - 10/31/2016 2 ZZ-ESTRADIOL 0.1MG PTCH (BRAND 10/31/2016

FENTANYL - PATCH 1 FENTANYL PATCH TS 25MCG/HR

FENTANYL PATCH TS 50MCG/HR

FENTANYL PATCH TS 75MCG/HR


User Manual

Orderable Items Report for High Risk/High Alert

The Orderable Items Report for High Risk / High Alert shows which Orderable Items have the

“High Risk / High Alert” flag set to a value of 1, 2, or 3:

1 HIGH RISK/ALERT-NO WITNESS REQUIRED IN BCMA 2 RECOMMEND WITNESS IN BCMA-HIGH RISK/ALERT

3 WITNESS REQUIRED IN BCMA-HIGH RISK/ALERT.

This allows the user to ensure the appropriate orderable items are designated as High Risk / High

Alert.

The user can access the Orderable Items Report for High Risk/High Alert from the PSS MGR

Pharmacy Data Management -> Orderable Item Management menu options.

This report will also:

• Allow the user to select ALL “High Risk / High Alert” (HR/HA) flag values of 1, 2,

and 3 (default) or specific values of 1, 2, or 3.

• Display help text when a single question mark “?’ is entered at the report parameter

prompt “Print Report for (A)ll or Specific HRHA Flag values(1,2,3): (A/1/2/3): A//?”

• Contain Orderable Item Name, Dosage Form, Orderable Item Inactive Date, High

Risk / High Alert flag value, Dispense Drug Name and Dispense Drug Inactive Date.

Example: Orderable Items Report for High Risk/High Alert [PSS HR/HA ODERABLE ITEMS RPT] Option

High Risk/High Alert for Orderable Items Report

Page 1

ORDERABLE ITEM OI INACTIVE HRHA DISPENSE DRUG (DD) DD INACTIVE

NAME - DOSAGE FORM DATE VAL NAME DATE

------------------------------ ------------ ---- ------------------------------ -----------

CEFAMANDOLE - INJ 2 CEFAMANDOLE 1GM INJ

CEFAMANDOLE 1GM FOR PROTOCOL 1

FUROSEMIDE - INJ,SOLN 3 FUROSEMIDE 10MG/ML INJ 4ML

FUROSEMIDE 10MG/ML 10ML INJ

FUROSEMIDE 10MG/ML 2ML INJ

HYDROCODONE 10MG/ACETAMINOPHEN 3 HYDROCODONE 10MG/ACETAMINOPHEN

INSULIN 70/30 (HUMAN) - INJ 3 INSULIN NOVOLIN 70/30 (NPH/REG

INSULIN,ASPART 70/30 NOVOLOG F

INSULIN, REGULAR (HUMAN) - INJ 1 INSULIN REG HUMAN 100 UNIT/ML

ZZZ LENTE U-100 INJ

ZZINSULIN LENTE U-100 INJ (POR

ZZINSULIN NPH U-100 INJ (PORK)

ZZINSULIN REG. U-100 INJ (PORK

INSULIN PROTAMINE ZINC U-100

INSULIN REG HUMAN 100 UNIT/ML

INSULIN SEMILENTE U-100 INJ

INSULIN ULTRA LENTE U-100 INJ

INSULIN,ASPART,HUMAN 100 UNIT/ 3 INSULIN,ASPART,HUMAN 100 UNIT/

WARFARIN - TAB 2 WARFARIN 1MG TAB

WARFARIN 2.5MG TAB

WARFARIN (COUMADIN) NA 10MG TA

WARFARIN (COUMADIN) NA 5MG TAB


User Manual

1.10 Formulary Information Report [PSS NFI]

The Formulary Information Report [PSS NFI] option provides a listing of pertinent Pharmacy

formulary information. The report is organized alphabetically by Dispense Drug but will also

display the Pharmacy Orderable Item to which the Dispense Drug is matched. An “N” in a

column indicates that the Dispense Drug is marked non-formulary at that level (Local, VISN, or

National). If the Dispense Drug is restricted, an “R” appears in the appropriate column.

The Application Package Use indicator is also displayed on the report. If the user selects to

include drug text in the report, an “I” will appear in the appropriate column to indicate drugs for

which drug text information has been identified in the DRUG file (#50).

Example: Formulary Information Report [PSS NFI] Option

Select Pharmacy Data Management Option: Formulary Information Report

This report shows the dispense drugs and orderable items

with the formulary information associated with them.


A ALL

S SELECT A RANGE


To see drugs beginning with the letter 'A', enter 'A', or whichever letter you

wish to see. To see drugs in a range, for example drugs starting with the


Select a Range: S

You have the choice to print the drug text information.

If you answer "yes" to the question, you will print all the drug text

information for both dispense drug and orderable items.

If you answer "no", you will print only formulary designations.

This report requires 132 columns.


Include drug text information ? NO// YES

Report will be for drugs starting with the letter S,

and ending with drugs starting with the letter S.


DEVICE: HOME// ;C-VT132 TELNET DEVICE

Formulary Information Report for Drugs from S through S

Date printed: JUN 25,2001 Page: 23

Generic Name Local Visn National Restriction Appl Drug

Pkg Text

Use

---------------------------------------------------------------------------------------------

STANOZOLOL 2MG UO

Orderable Item: XXX TAB

STERI-STRIPS O

Orderable Item: STERI STRIP


User Manual

STERILE GLOVES O

Orderable Item: STERILE GLOVE

STOMA CENTERING GUIDE O

Orderable Item: STOMA CENTERING GUIDE MISCELLANEOUS

STOMA GUIDE STRIP SG-603 O

Orderable Item: STOMA GUIDE STRIP

STOMAHESIVE COVERING 4X4 5S O

Orderable Item: COVERING STOMA CAP

STRAP, MONTGOMERY O

Orderable Item: MONTGOMERY STRAP DEVICE

STREPTOKINASE 250,000 IU 6.5ML UO

I

Orderable Item: STREPTOKINASE INJ

STREPTOKIONASE 750,000 UN INJ UO

I

Orderable Item: STREPTOKINASE INJ

STREPTOMYCIN SULFATE 1GM INJ UO

Orderable Item: STREPTOMYCIN INJ

STREPTOZOTOCIN INJ,1GM,ECOG O

Orderable Item: STREPTOZOTOCIN INJ

SUCCINYCHOLINE 1000MG S.P. UO

Orderable Item: SUCCINYLCHOLINE INJ,CONC-SOLN

SUCCINYCHOLINE 20MG/ML INJ R UO

Orderable Item: SUCCINYLCHOLINE INJ,SOLN

SUCRALFATE 1 GM TAB UO

Orderable Item: SUCRALFATE TAB

SULFACETAMIDE 10% OPTH SOL 15ML UO

Orderable Item: SULFACETAMIDE SOLN,OPH

SULFACETAMIDE OPHTH 10% OINT UO

Orderable Item: SULFACETAMIDE OINT,OPH

Enter RETURN to continue or '^' to exit:

1.11 Drug Text Management [PSS DRUG TEXT MANAGEMENT]

The Drug Text Management [PSS DRUG TEXT MANAGEMENT] menu option was created to

provide an umbrella for the options related to reviewing, entering and editing drug text.

1.11.1 Drug Text Enter/Edit [PSS EDIT TEXT]

The Drug Text Enter/Edit [PSS EDIT TEXT] option enables you to enter and/or edit entries in

the DRUG TEXT file (#51.7). This file contains drug information, restrictions, and guidelines.

Some entries are nationally populated by National Drug File. Drug text can be tied to a Dispense

Drug in DRUG file (#50), or it can be tied to a Pharmacy Orderable Item through the

PHARMACY ORDERABLE ITEM file (#50.7). Drug text tied to a Pharmacy Orderable Item is


User Manual

viewable when a medication is selected in Outpatient Pharmacy and Inpatient Medications, if it

has been tied to the Pharmacy Orderable Item or Dispense Drug.

The Drug Text Enter/Edit [PSS EDIT TEXT] option also enables you to view or print a report

and to list all drug and Pharmacy orderable items linked to it. See section 1.12.2, “Drug Text File

Report” for more information.

Example: Drug Text Enter/Edit [PSS EDIT TEXT] Option

Select Pharmacy Data Management Option: DRUG TEXT

1 Drug Text Enter/Edit

2 Drug Text File Report

CHOOSE 1-2: 1 Drug Text Enter/Edit

This option enables you to edit entries in the DRUG TEXT file.

Select DRUG TEXT NAME: C

1 CELECOXIB

2 CHF II

3 COPD

CHOOSE 1-3: 3 COPD

There may be entries in your DRUG file and PHARMACY ORDERABLE ITEM file linked

to this Drug Text Name. Editing information related to this Drug Text entry

will affect the display of information related to these.

Do you want to review the list of drugs and orderable items linked to this Drug

Text entry? ? YES// <Enter>


DEVICE: HOME// VIRTUAL Right Margin: 80// <Enter>

Drug Text Report for drug text : COPD

Date printed: JUL 16,2002 Page: 1

===============================================================================

PLEASE NOTE: The National Formulary Restriction Text is the original text

exported with the DRUG TEXT file (#51.7) and automatically linked to the DRUG

file (#50) entries based on the VA product match. No ORDERABLE ITEM file

(#50.7) entries were automatically linked with DRUG TEXT file (#51.7).

DRUG TEXT NAME: COPD

DRUG TEXT:

Refer to VA/DoD COPD treatment guidelines

NATIONAL FORMULARY RESTRICTION TEXT:


DRUG file entries:

-----------------

Enter RETURN to continue or '^' to exit: <Enter>

Drug Text Report for drug text: COPD


===============================================================================

DIGOXIN 0.125MG C.T.,

THEOPHYLLINE 200MG SUS-REL TABS



User Manual

ORDERABLE ITEM file entries:

---------------------------

NONE

----------------------------------------------------------------------

End of Report.


Do you want to edit the Drug Text Name? NO// <Enter>

IMPORTANT!! After editing the Drug Text Name OR Text, review the drugs and

orderable items linked to this entry for accuracy.

Do you want to edit the text for this entry? YES// <Enter>

TEXT:


Edit? NO// <Enter>


INACTIVATION DATE: <Enter>

Select DRUG TEXT NAME: ^

1.11.2 Drug Text File Report [PSS DRUG TEXT FILE REPORT]

This Drug Text File Report [PSS DRUG TEXT FILE REPORT] option will display the Drug

Text Name, Synonyms, Drug Text, Inactive date (if inactive), and list all drug and Pharmacy

orderable items linked to it. The report is printable for one or all entries.

For a list of the original entries in the DRUG TEXT file (#51.7), see Appendix B.

Example: Drug Text File Report [PSS DRUG TEXT FILE REPORT] Option

Select Pharmacy Data Management Option: DRUG TEXT FILE REPORT

This report shows each selected drug text entry and lists all drugs

and orderable items linked to it.


A ALL

S SINGLE ENTRY OR RANGE

Print for (A)ll or (S)elect Single Entry or Range: S// <Enter> SINGLE ENTRY OR RANGE

There are drugs in the drug text file with leading numerics.

Print report for drug text entries with leading numerics? N// <Enter>

Enter a single drug text entry or to see all drug text entries beginning with

the letter 'A' for example, enter 'A' or whichever letter you wish to see.

To see drug text entries in a range for example starting with 'H', 'I' and 'J'

enter in the format 'H-J'.

Enter a single entry or select a range: C

Report will be for drug text starting with C,

and ending with drug text starting with C.



User Manual


DEVICE: HOME// VIRTUAL Right Margin: 80// <Enter>

Drug Text Report for drug text from C through C


===============================================================================

PLEASE NOTE: The National Formulary Restriction Text is the original text

exported with the DRUG TEXT file (#51.7) and automatically linked to the DRUG

file (#50) entries based on the VA product match. No ORDERABLE ITEM file

(#50.7) entries were automatically linked with DRUG TEXT file (#51.7).

DRUG TEXT NAME: CELECOXIB

DRUG TEXT:

Refer to PBM/MAP criteria for use of celecoxib


DRUG file entries:

-----------------

CYCLOPHOSPHAMIDE 50MG C.T.

Enter RETURN to continue or '^' to exit: <Enter>



===============================================================================


---------------------------

NONE

----------------------------------------------------------------------

DRUG TEXT NAME: COPD

DRUG TEXT:







===============================================================================

DRUG file entries:

-----------------

DIGOXIN 0.125MG C.T.,




---------------------------

NONE

----------------------------------------------------------------------

End of Report.


User Manual


Select Pharmacy Data Management Option:

1.12 Pharmacy System Parameters Edit [PSS SYS EDIT]

The Pharmacy System Parameters Edit [PSS SYS EDIT] option allows the user to edit the

Pharmacy System Parameters used in PDM.

Example: Pharmacy System Parameters Edit [PSS SYS EDIT] Option

Select Pharmacy Data Management Option: Pharmacy System Parameters Edit

PMIS PRINTER: LASSIE PRINTER HALLWAY

PMIS LANGUAGE: ?

This language will be used as the default for the printing of Patient

Medication Instruction Sheets (PMIS).

Choose from:

1 English

2 Spanish

PMIS LANGUAGE: 1 English

WARNING LABEL SOURCE: ?

Enter "N" for NEW to use commercial data source for warning labels.

Choose from:

N NEW

WARNING LABEL SOURCE: N NEW

CMOP WARNING LABEL SOURCE: ?

Enter "N" for NEW to use commercial data source for CMOP warning labels.

Choose from:

N NEW

CMOP WARNING LABEL SOURCE: N NEW

OPAI WARNING LABEL SOURCE: ?

Enter "N" for NEW to use commercial data source for OPAI warning labels.

Choose from:

N NEW

OPAI WARNING LABEL SOURCE: N NEW

AUTOMATE CPRS REFILL: ?

Enter Y to process CPRS refills automatically or N to process manually in

Pharmacy backdoor.

Choose from:

0 NO

1 YES

AUTOMATE CPRS REFILL: NO//

ONEVA PHARMACY FLAG: ?

Select '1' to turn on the OneVA Pharmacy remote prescription logic. Select

'0' to turn it off.

Choose from:

1 ON

0 OFF

ONEVA PHARMACY FLAG:

Select Pharmacy Data Management Option:

A new field, ONEVA PHARMACY FLAG (#101) was created in the PHARMACY SYSTEM

File (#59.7) with Patch PSO*7*497. This field will allow sites to toggle the OneVA Pharmacy

logic 'on' or 'off' depending on current needs. The user changes the field value by using the

Pharmacy System Parameters Edit [PSS SYS EDIT] Option

Patch PSS*1*212 delivers the ONEVA PHARMACY FLAG field in the 'off' state. When this

flag is in the 'off' state, the HDR/CDS Repository is not queried for external prescriptions and

other VistA instances will not be able to refill prescriptions that belong to the VistA instance

with the flag set to the 'off' state. When in the 'on' state, all prescription queries and actions may


User Manual

be taken for remote queries, refills, and partial fills. In order to process prescriptions from

another VistA instance, that instance will also need to have its ‘ONEVA PHARMACY FLAG

set to the 'on' state.

***Important***

DO NOT turn on the OneVA Pharmacy Flag until directed to do so. The

software will be released, deployed, and installed with the activation flag set to

the “off” position. The Existing Product Intake Program (EPIP) Implementation

Team will coordinate with the sites Pharmacy Automatic Data Processing

Application Coordinator (ADPAC) on the specific date in which to activate the

software.

1.13 Standard Schedule Management [PSS SCHEDULE MANAGEMENT]

The Standard Schedule Management [PSS SCHEDULE MANAGEMENT] option was created

to provide an umbrella for all the options related to working with standard schedules.

1.13.1 Standard Schedule Edit [PSS SCHEDULE EDIT]

The Standard Schedule Edit [PSS SCHEDULE EDIT] option allows the user to enter or edit

entries in the ADMINISTRATION SCHEDULE file (#51.1). The set of times associated with

the standard dosage administration schedules can be assigned, as can ward-specific

administration times. This feature may be used to define the outpatient expansion to be used

when the schedule is entered for an Outpatient Pharmacy medication order. Entry of a frequency

in minutes allows the software to calculate the interval between dosages for Inpatient Medication

orders and BCMA and is used by Outpatient Pharmacy to calculate default quantities. When the

frequency is entered, a message displays telling the user, in hours, how often the administration

will occur. If the schedule type is on call, the system does not require a frequency.

Schedules with a frequency that is not evenly divisible into or by 24 hours are considered ‘odd’.

Odd schedules are not allowed to have administration times. If the schedule type is continuous

and it is an odd schedule, the system does not allow the entry of administration times.

Continuous, non-odd schedules still require administration times.

The Standard Schedule Edit [PSS SCHEDULE EDIT] option allows the user to enter the

outpatient expansion value in a language other than English. PDM does not translate English

terms into another language; instead, it allows the user to enter a translation of a term. If a value

has not been entered in the OTHER LANGUAGE EXPANSION field (#8.1), PDM defaults to

the value entered in the OUTPATIENT EXPANSION field (#8). If no values exist in the

OUTPATIENT EXPANSION (#8) and OTHER LANGUAGE EXPANSION fields (#8.1), the

system will not present default values for those fields to the user during CPRS or Outpatient

Pharmacy prescription order processing. However, when building the SIG, Outpatient Pharmacy

will default to the value the user input through Outpatient Pharmacy backdoor order entry. See


User Manual

Appendix C for a list of Spanish equivalents for some of the more common administration

schedules.

Note: A schedule name of OTHER is not allowed. This name is used to allow building a

Day-of-Week and/or admin-time schedule in CPRS.

Example: Standard Schedule Edit [PSS SCHEDULE EDIT] Option

Select Pharmacy Data Management Option: STAndard Schedule Edit

Select ADMINISTRATION SCHEDULE: BID

NAME: BID// <Enter>

OUTPATIENT EXPANSION: TWO TIMES A DAY// <Enter>

OTHER LANGUAGE EXPANSION: DOS VECES AL DIA

TYPE OF SCHEDULE: CONTINUOUS// <Enter>

STANDARD ADMINISTRATION TIMES: 0900-1700// <Enter>

FREQUENCY (IN MINUTES): 720// <Enter>

Select WARD ADMINISTRATION SCHEDULE: <Enter>

PSS*1*160 enhances the Standard Schedule Edit [PSS SCHEDULE EDIT] option to allow

editing of two new dosing exclusion fields that were added to the ADMINISTRATION

SCHEDULE file (#51.1) in MOCHA v2.0. The two new fields are EXCLUDE FROM ALL

DOSING CHECKS field (#9) and EXCLUDE FROM DAILY DOSE CHECK field (#10).

The EXCLUDE FROM DAILY DOSE CHECK field (#10) allows a user to exclude a standard

schedule from the Daily Dose Range check. If a schedule is entered for a medication order that

has this field set to ‘Yes’, no Daily Dose Range check will be performed on the drug within the

order. The Maximum Single Dose order check will still be performed.

Note: The Daily Dose Range check will be implemented in a future version of MOCHA.

The Maximum Single Dose order check is introduced with MOCHA v 2.0.

If the schedule being edited has a schedule type of ON CALL or ONE TIME, the EXCLUDE

FROM DAILY DOSE CHECK prompt will not be displayed. If the EXCLUDE FROM ALL

DOSING CHECKS field (#9) is set to YES, the EXCLUDE FROM DAILY DOSE CHECK

field (#10) will not be displayed for editing.

Example 1: Both fields displayed for editing

Select Standard Schedule Management Option: STANDARd Schedule Edit

Select ADMINISTRATION SCHEDULE: BID

1 BID 09-17

2 BID PRN

3 BID-AM 01

4 BID-NOON 12

5 BID-PRN


CHOOSE 1-5: 1 09-17

NAME: BID//

OUTPATIENT EXPANSION: TWICE A DAY//



User Manual

TYPE OF SCHEDULE: CONTINUOUS//

EXCLUDE FROM ALL DOSING CHECKS:

EXCLUDE FROM DAILY DOSE CHECK:

FREQUENCY (IN MINUTES): 720//

The schedule entered equals 12 hours.

STANDARD ADMINISTRATION TIMES: 09-17//

Select WARD:

Select ADMINISTRATION SCHEDULE:

Example 2: One-time Schedule displayed for editing

Select Standard Schedule Management Option: Standard Schedule Edit

Select ADMINISTRATION SCHEDULE: one-t

Are you adding 'ONE-T' as a new ADMINISTRATION SCHEDULE (the 103RD)? No// n

(No) ??

Select ADMINISTRATION SCHEDULE: now ONE-TIME

NAME: NOW//

OUTPATIENT EXPANSION:


TYPE OF SCHEDULE: ONE-TIME//


Select ADMINISTRATION SCHEDULE

Patch PSS*1*201 adds three new fields to the Standard Schedule Edit [PSS SCHEDULE EDIT]

option. The DOSING CHECK FREQUENCY field (#11) allows a user to enter a specific format

pattern to represent the frequency such as ‘X#D’, where ‘#’ represents a 1-2 character numeric

value. The DOSING CHECK FREQUENCY field takes priority over all other fields/values

when determining frequency for the Max Daily Dose Order Check. If the DOSING CHECK

FREQUENCY value is not used, the FREQUENCY (IN MINUTES) value will be used for the

Max Daily Dose Order Check. When determining frequency, the ADMINISTRATION

SCHEDULE File (#51.1) will take precedence over the MEDICATION INSTRUCTION File

(#51) for outpatient medication orders. Only the ADMINISTRATION SCHEDULE File (#51.1)

will be utilized to determine a frequency value for inpatient medication orders.

The DRUG(S) FOR DOSING CHK FREQ field (#11.1) is a multiple field that allows for

dispense drugs from the DRUG file (#50) to be associated with the DOSING CHECK

FREQUENCY field (#32) value within the ADMINISTRATION SCHEDULE file (#51.1).

When a value is entered in the DOSING CHECK FREQUENCY field and NO drug(s) is entered

in this field, the Max Daily Dose Order Check will use the value in the DOSING CHECK

FREQUENCY field to derive a frequency for all orders that have that schedule. When a value is

entered for DOSING CHECK FREQUENCY and a drug(s) is entered in this field, the Max Daily

Dose Order Check will ONLY use the value in DOSING CHECK FREQUENCY to derive a

frequency if the order that has that schedule also matches one of the drug(s) entered. If the drug

found in the order does not match a drug listed in the DRUG(S) FOR DOSING CHK FREQ

field, then the value of the DOSING CHECK FREQUENCY will not be used for the Max Daily

Dose Order Check to derive a frequency.

Example: Standard Schedule Edit [PSS SCHEDULE EDIT] Option

Select Pharmacy Data Management <TEST ACCOUNT> Option: STANDard Schedule Management

Select Standard Schedule Management <TEST ACCOUNT> Option: STANdard Schedule Edit


User Manual

Select ADMINISTRATION SCHEDULE: MO-WE-FR 09

NAME: MO-WE-FR//



Select OLD SCHEDULE NAME(S):

INACTIVE:

TYPE OF SCHEDULE: DAY OF THE WEEK//



DOSING CHECK FREQUENCY: X3W// ?


The numeric limit is 99, except for the following formats:

Q#W - Maximum 28 weeks allowed

Q#L - Maximum 6 months allowed

Enter '??' to view the available dosing check frequency formats

for this field.

DOSING CHECK FREQUENCY: X3W// ??

The DOSING CHECK FREQUENCY field takes priority over all other

fields/values when determining frequency.

PLEASE BE AWARE that the format of the frequency in this field must

employ the format patterns of the vendor database, which always places

the numeric value in the middle position of the schedule. In some

cases an 'X' (symbol for 'times') must be entered as the first

character, although it is still translated as the number of times per

designated period.

The text examples within the following brackets [] provide clarification

of the literal schedule translation for the possible formats. Enter the

dosing check frequency in one of the following specified formats (#

represents a whole number):

Q#H [every # hour(s), such as every 5 hours]

Q#D [every # day(s), such as every 3 days]

Q#W [every # week(s), such as every 5 weeks]

Q#L [every # month(s), such as every 3 months]

X#D [times per day, such as 17 times per day]

X#W [times per week, such as 3 times per week]

X#L [times per month, such as 4 times per month]

Numeric value can be 1-2 characters.

DOSING CHECK FREQUENCY: X3W//

Select DRUG(S) FOR DOSING CHK FREQ: EPOETIN ALFA,RECOMBINANT 10000UNT/ML INJ

// ?

Answer with DRUG(S) FOR DOSING CHK FREQ:

EPOETIN ALFA,RECOMBINANT 10000UNT/ML INJ


Select a dispense drug to be associated with the dosing check

frequency.

Answer with DRUG NUMBER, or GENERIC NAME, or VA PRODUCT NAME, or

NATIONAL DRUG CLASS, or NDC, or APPLICATION PACKAGES' USE, or

ATC MNEMONIC, or DRUG TEXT ENTRY, or SYNONYM

Do you want the entire 1804-Entry DRUG List? N (No)

Select DRUG(S) FOR DOSING CHK FREQ: EPOETIN ALFA,RECOMBINANT 10000UNT/ML INJ

// ??



User Manual

This field allows a dispense drug from the DRUG (#50) file to be

associated with the DOSING CHECK FREQUENCY (#11) field value within

the ADMINISTRATION SCHEDULE (#51.1) file.

When a value is entered for "DOSING CHECK FREQUENCY:" and NO drug(s) is

entered for "Select DRUG(S) FOR DOSING CHK FREQ:",the dosing check will

use the value for "DOSING CHECK FREQUENCY:" to derive a frequency for

all orders that have that schedule.

When a value is entered for "DOSING CHECK FREQUENCY:" and a drug(s) is

entered for "Select DRUG(S) FOR DOSING CHK FREQ:", the Daily Dose Order

Check will ONLY use the value in "DOSING CHECK FREQUENCY:" to derive a

frequency if the order that has that schedule also matches one of the

drug(s) entered. If the drug found in the order does not match a drug

listed in the DRUG(S) FOR DOSING CHK FREQ field, then the value of the

DOSING CHECK FREQUENCY will not be used for the Daily Dose Order Check.

STANDARD ADMINISTRATION TIMES: 09//

Select WARD:

If the schedule being edited has a schedule type of ON CALL or ONE-TIME, or has a value of

‘Yes’ entered in the EXCLUDE FROM ALL DOSING CHECKS field (#9) or EXCLUDE

FROM DAILY DOSE CHECK field (#10), the DOSING CHECK FREQUENCY and DRUG(S)

FOR DOSING CHK FREQ prompts will not be displayed.

Example: Editing of One-Time Schedule

Select Pharmacy Data Management Option: standard Schedule Management

Select Standard Schedule Management <TEST ACCOUNT> Option: standard Schedule Edit

Select ADMINISTRATION SCHEDULE: now ONE-TIME

NAME: NOW//




INACTIVE:

TYPE OF SCHEDULE: ONE-TIME//


For schedules types of Day of the Week or PRN where a FREQUENCY (IN MINUTES) value is

not defined, DOSING CHECK FREQUENCY and DRUG(S) FOR DOSING CHK FREQ

prompts will be displayed and values can be defined.

Example: Editing of One-Time Schedule

Select ADMINISTRATION SCHEDULE: bid

1 BID

2 BID PRN

CHOOSE 1-5: 2

NAME: BID PRN//




INACTIVE:

TYPE OF SCHEDULE: PRN//

The Type of Schedule has changed, the frequency will be removed






User Manual

The third field added by patch PSS*1*201, OLD SCHEDULE NAME(S) (#13), is a multiple

field which is automatically populated by the software when the user modifies the NAME field

(#.01) of the schedule. Values can also be added to this field directly. More than one old

schedule name is allowed for a schedule. No two schedules can have the same old schedule

name. A schedule name cannot be edited to match an old schedule name found anywhere in the

ADMINISTRATION SCHEDULE file (#51.1). The reverse also holds true. An old schedule

name cannot be edited to match a schedule name found anywhere in the ADMINISTRATION

SCHEDULE file (#51.1).The OLD SCHEDULE NAME(s) field (#13) will used to lookup a

schedule entered for an order to derive a frequency value for the Max Daily Dose Order Check.

Example : Edit Schedule Name

The modified name ‘QDAY’ is automatically added to the OLD SCHEDULE NAME(S)

multiple when the schedule name is edited to ‘QDAILY’.

Select Pharmacy Data Management <TEST ACCOUNT> Option: STANDARD Schedule Management

Select Standard Schedule Management <TEST ACCOUNT> Option: STANDARD Schedule Edit

Select ADMINISTRATION SCHEDULE: QDAY 08

NAME: QDAY// QDAILY

OUTPATIENT EXPANSION: EVERY DAY//


Select OLD SCHEDULE NAME(S): QDAY//

INACTIVE:







The schedule entered equals 1 day.


Select WARD:

Example : Attempt to add new schedule with same name as existing old schedule name in file

A notification is displayed with the duplicate schedule name and internal entry number in

parenthesis. The action is blocked when a user attempts to add a new schedule with the same

name as an existing old schedule name in the file.

Select ADMINISTRATION SCHEDULE: QDAY

Duplicate exists in Old Schedule Name multiple for the entry

QDAILY (95) in the file. Please enter a new name.

Select ADMINISTRATION SCHEDULE:

Example : Attempt to edit schedule name to match existing old schedule name in file

A notification is displayed and the action is blocked when a user attempts to edit a schedule

name to match an existing old schedule name in the file.

Duplicate Old Schedule Name is found in entry user is editing Select ADMINISTRATION SCHEDULE: QDAILY 08

NAME: QDAILY// QDAY


User Manual

A duplicate exists in the OLD SCHEDULE NAME(S) multiple for this entry.




INACTIVE:









Select WARD:


Select ADMINISTRATION SCHEDULE: QD

NAME:QDAILY// DAILY

A duplicate exists in the OLD SCHEDULE NAME(S) multiple for the entry

EVERY DAY (94).




INACTIVE:









Select WARD:

Example : Attempt to directly enter old schedule name that is a duplicate of existing old schedule name in file

If a user attempts to directly enter an old schedule name that is a duplicate of an existing old

schedule name somewhere in the file, the action is blocked and a notification is displayed.

Select ADMINISTRATION SCHEDULE: QDAILY 08

NAME: QDAILY//



Select OLD SCHEDULE NAME(S): QDAY// DAILY

Duplicate exists in Old Schedule Name multiple for the entry

EVERY DAY (94) in the file. Please enter a new name.


INACTIVE:









Select WARD:


User Manual

Example: Attempt to directly edit an old schedule name to match an existing NAME field anywhere in the

file

If a user attempts to directly edit an old schedule name to match an existing schedule NAME

field anywhere in the file, the action will be blocked and a notification displayed.

Select ADMINISTRATION SCHEDULE: QDAILY 08

NAME: QDAILY//



Select OLD SCHEDULE NAME(S): QDAY// QDAY

Lookup: OLD SCHEDULE NAME(S)

QDAY

...OK? Yes// (Yes)

OLD SCHEDULE NAME(S): QDAY// QDAILY

An OLD SCHEDULE NAME(S) entry cannot be the same as an existing NAME

field.


INACTIVE:









Select WARD:

PSS Schedule Edit Option Validation

Validation checks were added to the Standard Schedule Edit [PSS SCHEDULE EDIT] option to

prevent the Standard Administration Times, Ward Administration Times, Frequency and

Schedule Type fields of a schedule from conflicting with one another.

Schedule Edit Validation One

The system shall validate, for schedules with a Schedule Type of Continuous and a frequency of

1 day (1440 minutes) or less that the number of administration times is less than or equal to 1440

divided by the frequency. For example, a schedule frequency of 720 minutes must have at least

one administration time and cannot exceed two administration times. Similarly, a schedule

frequency of 360 minutes must have at least one administration time but cannot exceed four

administration times.

The system shall present warning/error messages to the user if the number of administration

times is less than or greater than the maximum admin times calculated for the schedule or if no

administration times are entered. If the number of administration times entered is less than the

maximum admin times calculated for the schedule, the warning message: “The number of admin

times entered is fewer than indicated by the schedule.” shall appear. In this case, the user will be

allowed to continue after the warning. If the number of administration times entered is greater

than the maximum admin times calculated for the schedule, the error message: “The number of

admin times entered is greater than indicated by the schedule.” shall appear. The user will not be

allowed to accept the order until the number of admin times is adjusted. If no admin times are


User Manual

entered, the error message: “This order requires at least one administration time.” shall appear.

The user will not be allowed to accept the order until at least one admin time is entered.

Schedule Edit Validation Two

The system shall validate for frequencies greater than one day (1440 minutes), that only one

administration time is permitted. The system shall present an error message to the user if more

than one administration time is entered.

The error message: “This schedule has a frequency greater than one day (1440 minutes). More

than one Administration Time is not permitted.” shall appear if more than one administration

time is entered.

Schedule Edit Validation Three

In the Standard Administration Times and the Ward Administration Times fields in the Standard

Schedule Edit [PSS SCHEDULE EDIT] option, for a schedule that has a Schedule Type of

Continuous, the system shall prevent a user from entering administration times to Odd Schedules

{a schedule whose frequency is not evenly divisible by or into 1440 minutes (1 day)}.

The system shall present an error message to the user if an administration time is entered. The

error message: “This is an odd schedule that does not require administration times. BCMA will

determine the administration times based off the start date/time of the medication order.” shall

appear.

Schedule Edit Validation Four

A validation to TYPE OF SCHEDULE field (#5) in the Standard Schedule Edit [PSS

SCHEDULE EDIT] option was added to remove

frequency from the schedule file entry, if the TYPE OF SCHEDULE is changed from

CONTINUOUS to ONE TIME, PRN, ON CALL, or DAY OF WEEK.

The warning message: “The Type of Schedule has changed. The frequency will be removed.”

shall appear.

Schedule Edit Validation Five

In the Standard Schedule Edit [PSS SCHEDULE EDIT] option, the system shall prevent a user

from creating Day of Week (DOW) schedules that are not in the correct day of week order. The

correct order is: SU-MO-TU-WE-TH-FR-SA. The system shall display an error message if the

user does not enter the correct order.

The error message: “The day of the week schedule must be in the correct day of week order. The

correct order is: SU-MO-TU-WE-TH-FR-SA.” shall appear.

Schedule Edit – Inactivate

In the Standard Schedule Edit [PSS SCHEDULE EDIT] option, the user can inactivate a

Standard Schedule. This is done so that the Standard Schedule is not shown in CPRS and cannot


User Manual

be selected by the provider creating an order. In the Standard Schedule Maintenance option the

following is shown to inactivate:

Example: Inactive Administration Schedule

Select ADMINISTRATION SCHEDULE: Q4HPRN 01-05-09-13-17-21 NAME: Q4HPRN// OUTPATIENT EXPANSION: OTHER LANGUAGE EXPANSION: INACTIVE: ? Answer YES to mark this administration schedule entry as inactive. Choose from: 1 YES INACTIVE: ?? This field is used to indicate that a Standard Schedule is inactive. Inactive schedules are filtered from the list of schedules sent to CPRS for selection when users are placing a medication order. Choose from: 1 YES INACTIVE: ??? This field is used to indicate that a Standard Schedule is inactive. Inactive schedules are filtered from the list of schedules sent to CPRS for selection when users are placing a medication order. Choose from: 1 YES INACTIVE:

1.13.2 Administration Schedule File Report [PSS SCHEDULE REPORT]

The Administration Schedule File Report [PSS SCHEDULE REPORT] option prints out entries from the ADMINISTRATION SCHEDULE file (#51.1) in order to check to see if a frequency is defined. A report can be run for all administration schedules or only the administration schedules without a defined frequency. Only administration schedules with a PACKAGE PREFIX field (#4) in the ADMINISTRATION SCHEDULE file (#51.1) set to ‘PSJ’ will be included in the report. The report can be set to print in either an 80 or 132 column format.

PSS*1*160 enhances the Administration Schedule File Report [PSS SCHEDULE REPORT] option to allow the display of data from the two new fields; EXCLUDE FROM ALL DOSING CHECKS field (#9) and EXCLUDE FROM DAILY DOSE CHECK field (#10) that were added to the ADMINSTRATION SCHEDULE file (#51.1).

PSS*1*201 enhances the Administration Schedule File Report [PSS SCHEDULE REPORT] option

to allow the display of data from three new fields; DOSING CHECK FREQUENCY field (#11),

DRUG(S) FOR DOSING CHK FREQ field (#11.1) and OLD SCHEDULE NAME(S) field

(#13).

Example: Only administration schedules without a frequency defined.

Select Enhanced Order Checks Setup Menu Option: ADMINistration Schedule File Report

This report displays entries from the ADMINISTRATION SCHEDULE (#51.1) File. It can be run for all Schedules, or only Schedules without a FREQUENCY (IN MINUTES). Only schedules with a PSJ Package Prefix will be displayed, since they are the only schedules the software will look at when deriving a FREQUENCY (IN MINUTES) for the daily dosage checks. If a FREQUENCY (IN MINUTES) cannot


User Manual

be determined for an order, the daily dosage check cannot occur for that order.

Select one of the following: A All Schedules

O Only Schedules with a missing frequency Print All Schedules, or Only Schedules without a frequency: A// Only Schedules with a missing frequency Select one of the following: 80 80 Column 132 132 Column

Print report in 80 or 132 column format: 80// <ENTER> Column DEVICE: HOME// <ENTER> ADMINISTRATION SCHEDULE WITHOUT FREQUENCY REPORT PAGE: 1 -----------------------------------------------------------------------------

BID-W/MEAL STANDARD ADMINISTRATION TIMES: 09-17

OUTPATIENT EXPANSION: TWICE DAILY WITH MEAL OTHER LANGUAGE EXPANSION: OLD SCHEDULE NAME(S): SCHEDULE TYPE: FREQUENCY (IN MINUTES):

EXCLUDE FROM ALL DOSE CHECKS: EXCLUDE FROM DAILY DOSE CHECK: DOSING CHECK FREQUENCY: DRUG(S) FOR DOSING CHK FREQ:

INACTIVE:

Q12H STANDARD ADMINISTRATION TIMES: 0900-2100 OUTPATIENT EXPANSION: EVERY 12 HOURS OTHER LANGUAGE EXPANSION: OLD SCHEDULE NAME(S): SCHEDULE TYPE:

FREQUENCY (IN MINUTES): EXCLUDE FROM ALL DOSE CHECKS:

EXCLUDE FROM DAILY DOSE CHECK: DOSING CHECK FREQUENCY: DRUG(S) FOR DOSING CHK FREQ: INACTIVE:

End of Report.

The Administration Schedule File Report [PSS SCHEDULE REPORT] was updated to display INACTIVE : YES for those administration schedules that have been inactivated. Inactive schedules are filtered from the list of schedules sent to CPRS but are still selectable from backdoor pharmacy.

Example: Administration Schedule File Report ADMINISTRATION SCHEDULE FILE REPORT (All) PAGE: 5 ----------------------------------------------------------------------------- SCHEDULE TYPE: CONTINUOUS FREQUENCY (IN MINUTES): 720 EXCLUDE FROM ALL DOSE CHECKS: EXCLUDE FROM DAILY DOSE CHECK: DOSING CHECK FREQUENCY: DRUG(S) FOR DOSING CHK FREQ: INACTIVE: YES BID-PRN STANDARD ADMINISTRATION TIMES: OUTPATIENT EXPANSION: OTHER LANGUAGE EXPANSION: OLD SCHEDULE NAME(S): SCHEDULE TYPE: PRN FREQUENCY (IN MINUTES):


User Manual

EXCLUDE FROM ALL DOSE CHECKS: EXCLUDE FROM DAILY DOSE CHECK: DOSING CHECK FREQUENCY: DRUG(S) FOR DOSING CHK FREQ: INACTIVE: BID-PRN STANDARD ADMINISTRATION TIMES: 11-18

1.14 Synonym Enter/Edit [PSS SYNONYM EDIT]

The Synonym Enter/Edit [PSS SYNONYM EDIT] option allows the user to enter synonym

information into the SYNONYM multiple (#9) of the DRUG file (#50) for a selected Dispense

Drug. Synonyms are used to easily identify drugs for the BCMA package and the Drug

Accountability package, and to simplify medication order entry.

Example 1: Creating a New Synonym

Select DRUG GENERIC NAME: NAP

1 NAPROXEN 250MG S.T. MS102 N/F 09-05-00

2 NAPROXEN 375MG TAB MS102

CHOOSE 1-2: 2 NAPROXEN 375MG TAB MS102

Select SYNONYM: 018393027342// ALEVE

INTENDED USE: TRADE NAME

NDC CODE: <Enter>


Example 2: Deleting a Synonym

Select DRUG GENERIC NAME: NAP

1 NAPROXEN 250MG S.T. MS102 N/F 09-05-00

2 NAPROXEN 375MG TAB MS102

CHOOSE 1-2: 2 NAPROXEN 375MG TAB MS102

Select SYNONYM: ALEVE// @

SURE YOU WANT TO DELETE THE ENTIRE 'ALEVE' SYNONYM? Y (Yes)

Select SYNONYM: 018393027342// <Enter>

SYNONYM: 018393027342// <Enter>

INTENDED USE: DRUG ACCOUNTABILITY// <Enter>

NDC CODE: 018393-0273-42// <Enter>


The Section that was numbered 1.15 and entitled Other Language Translation Setup has been

removed. A new section, Stand-Alone Menu Options, has been added at the end of this chapter.

It contains a new stand-alone menu option and the Other Language Translation Setup option and

its examples.

Also note that even though page numbering is not affected except where change pages have been

created, the heading numbers have been moved back one number; thus, all the appropriate pages

have been included in the change pages document for patches PSS*1*136 and PSS*1*117.

1.15 Controlled Substances/PKI Reports [PSS CS/PKI REPORTS]

A post-installation routine for patch PSS*1*61 identifies those drugs with discrepancies between

the CS FEDERAL SCHEDULE field (#19) of the VA PRODUCT file (#50.68) and DEA,


User Manual

SPECIAL HDLG field (#3) of the DRUG file (#50), and generates four mail messages with the

following subjects to the installer and to holders of the PSNMGR keys:

• CS FEDERAL SCHEDULE AND DEA, SPECIAL HDLG DISCREPANCIES

• CONTROLLED SUBSTANCES NOT MATCHED

• CONTROLLED SUBSTANCES NOT SET CORRECTLY

• DISCREPANCY IN DEA WITHIN DRUGS TIED TO AN OI

These mail messages can be used to clean up the DEA, SPECIAL HDLG code in the DRUG

file (#50) where appropriate.

The post-install also checks to see if the DEA, SPECIAL HDLG field (#3) of the DRUG file

(#50) is null and if the drug is matched to an entry in the VA PRODUCT file (#50.68), and the

CS FEDERAL SCHEDULE field (#19) of the VA PRODUCT file (#50.68) has data, then it

updates the DEA, SPECIAL HDLG field (#3) of the DRUG file (#50) with the DEA, SPECIAL

HDLG code mapped to corresponding CS FEDERAL SCHEDULE code.

This new Controlled Substances/PKI Reports [PSS CS/PKI REPORTS] option is added to the

Pharmacy Data Management menu to re-generate these post-install Mailman messages on

demand.

1.16 Send Entire Drug File to External Interface [PSS MASTER FILE ALL]

This option sends updated information for every entry in the DRUG file (#50) to the external

interface for Outpatient Pharmacy dispensing systems, using HL7 standard V. 2.4 messages. All

entries are sent, regardless of how they are marked for Application Package Use.

To use this option, the following items must be set up properly in the OUTPATIENT SITE file

(#59):

• In the AUTOMATED DISPENSE field (#105), the value should be set to V. 2.4. This

enables sending data through the Interface Engine using HL7 V. 2.4 standard.

• In the ENABLE MASTER FILE UPDATE field (#105.2), the value should be set to

YES.

• In the DISPENSE DNS NAME field (#2006), there should be some value defined. This

value sends the DNS name of the dispensing system (for example,

dispensemachine1.vha.med.va.gov) to the Interface Engine, so that the Interface Engine

knows where to route the HL7 messages.

Example: Send Entire Drug File to External Interface [PSS MASTER FILE ALL] Option

Select Pharmacy Data Management Option: PSS MASTER FILE ALL Send Entire Drug File to

External Interface


Press RETURN to continue...


User Manual

The Enhanced Order Checks Setup Menu options are located here on the main menu. Because

this menu will be removed when PRE V.0.5 is released, the descriptions have been moved to the

end of this chapter (1.23).

Current functionality in the PDM package is that when a new drug is entered, information is sent

to the OPAI, if one is defined. Patches PSS*1*156 and PSO*7*354 provide the ability of adding

more than one dispensing device per division. It was recommended that this particular option not

be enhanced with the multiple ADD capability since it is not currently used. Sites make manual

entries of drugs into the console of the dispensing devices directly.

1.17 IV Additive/Solution [PSS ADDITIVE/SOLUTION]

The IV Additive/Solution [PSS ADDITIVE/SOLUTION] option was created by Patch

PSS*1*147 to provide an umbrella for all the options related to reviewing IV Additive and IV

Solution data. Note that with the advent of Patch PSS*1*117, the menu reads IV

Additive/Solution [PSS ADDITIVE/SOLUTION] option and the Mark PreMix Solutions [PSS

MARK PREMIX SOLUTIONS] option has been added.

1.17.1 IV Additive Report

[PSS IV ADDITIVE REPORT]

Patch PSS*1*147 creates a new IV Additive Report [PSS IV ADDITIVE REPORT] option to

display IV Additive information. A user can select to display only entries marked with '1

BAG/DAY' in the ADDITIVE FREQUENCY field (#18), or only those entries with nothing

entered in the ADDITIVE FREQUENCY field (#18), or all entries can be displayed. The report

will print the following data elements:

• Print Name

• Generic Drug

• Drug Unit

• Synonyms

• Pharmacy Orderable Item

• Inactivation Date

• Used in IV Fluid Order Entry

• Additive Frequency

If the user chooses to print only the IV Additives marked with ‘1 BAG/DAY’ in the ADDITIVE

FREQUENCY field (#18) or those entries with nothing entered in the ADDITIVE

FREQUENCY field (#18)and none are found, the report will display ‘No IV Additives marked

as '1 BAG/DAY' or ‘No IV Additives marked as null’ respectively. Example 1: User selects only IV Additives marked with no value in the ADDITIVE FREQUENCY Field (#18)

Select IV Additive/Solution Reports Option: IV ADditive Report

This report displays entries in the IV ADD (#52.6) File. You can select


User Manual

to display only entries marked with '1 BAG/DAY' in the ADDITIVE FREQUENCY (#18)

Field, or only those entries with nothing entered in the ADDITIVE FREQUENCY

(#18) Field, or all entries can be displayed.


1 Print entries marked as '1 BAG/DAY' for ADDITIVE FREQUENCY

N Print entries marked as Null for ADDITIVE FREQUENCY

A Print all IV Additives

Print which IV Additives: A// N Print entries marked as Null for ADDITIVE FREQUENCY



:

:

IV Additives marked as null for ADDITIVE FREQUENCY Page: 1

------------------------------------------------------------------------------

Print Name: CALCIUM GLUCONATE

Drug Unit: MEQ

Synonyms: CAGLUC

Generic Drug: CALCIUM GLUCONATE 1GM

Pharmacy Orderable Item: CALCIUM GLUCONATE INJ,SOLN

Inactivation Date:

Used in IV Fluid Order Entry: YES

Additive Frequency:

Print Name: POTASSIUM CHLORIDE

Drug Unit: MEQ

Synonyms: KCL

Generic Drug: POTASSIUM CL 2MEQ/ML (10ML) INJ

Pharmacy Orderable Item: POTASSIUM CHLORIDE INJ,SOLN

Inactivation Date:


Additive Frequency:

End of Report.

Example 2: User Selects Only IV Additives marked with ‘1BAG/DAY’ in the ADDITIVE FREQUENCY Field (#18)

Select IV Additive/Solution Reports Option: IV ADDitive Report

This report displays entries in the IV ADDITIVES (#52.6) File. You can select


Field, or only those entries with nothing entered in the ADDITIVE FREQUENCY (#18) Field, or

all entries can be displayed.





Print which IV Additives: A// 1 Print entries marked as '1 BAG/DAY' for ADDITIVE FREQUENCY



IV Additives marked as '1 BAG/DAY' for ADDITIVE FREQUENCY Page: 1

------------------------------------------------------------------------------

No IV Additives marked as '1 BAG/DAY'.

End of Report.


User Manual

Example 3: User selects all IV Additives

Select IV Additive/Solution Reports Option: IV Additive Report

This report displays entries in the IV ADDITIVES (#52.6) File. You can select


Field, or only those entries with nothing entered in the ADDITIVE FREQUENCY(#18)

Field, or all entries can be displayed.





Print which IV Additives: A// <ENTER> Print all IV Additives



All IV Additives Page: 1

------------------------------------------------------------------------------

Print Name: AMINOPHYLLINE

Drug Unit: MG

Synonyms:

Generic Drug: AMINOPHYLLINE 25MG/ML 20ML INJ

Pharmacy Orderable Item: AMINOPHYLLINE INJ,SOLN

Inactivation Date:


Additive Frequency: ALL BAGS

Print Name: CALCIUM GLUCONATE

Drug Unit: MEQ

Synonyms: CAGLUC

Generic Drug: CALCIUM GLUCONATE 1GM

Pharmacy Orderable Item: CALCIUM GLUCONATE INJ,SOLN

Inactivation Date:


Additive Frequency:

Print Name: HEPARIN

Drug Unit: UNITS

Synonyms:

Generic Drug: HEPARIN 10,000 UNITS 4ML

Pharmacy Orderable Item: HEPARIN INJ,SOLN

Inactivation Date:


Additive Frequency: ALL BAGS

Print Name: TRACE ELEMENTS

Drug Unit: ML

Synonyms:

Generic Drug: TRACE ELEMENTS 5ML INJ

Pharmacy Orderable Item: TRACE ELEMENTS INJ,CONC-SOLN

Inactivation Date:


Additive Frequency: 1 BAG/DAY

End of Report.

1.17.2 IV Solution Report [PSS IV SOLUTION REPORT]

The IV Solution Report [PSS IV SOLUTION REPORT] option displays only IV solutions marked

as PreMixes or all IV solutions.


User Manual

The report will print the following data elements:

• Print Name

• Print Name {2}

• Volume

• Synonyms

• Generic Drug

• Pharmacy Orderable Item



• PreMix

If the user chooses to print only the IV solutions marked as PreMixes and none are found the

report will display ‘No IV Solutions marked as PreMixes found.’ Example 1: User selects only solutions marked as PreMix

Select Enhanced Order Checks Setup Menu Option: IV SOLUTION Report This report displays only those solutions in the IV Solutions (#52.7) File that are marked as PreMix IV Solutions, or it displays all Solutions. Select one of the following:

P Print only IV Solutions marked as PreMix

A Print All IV Solutions Print report for PreMix (P), or All IV Solutions (A): (P/A): Premix: P// <ENTER> rint only IV Solutions marked as PreMix

This report is designed for 80 column format! DEVICE: HOME// <ENTER>

Solution PreMix report for IV Solutions marked as PreMix Page: 1 --------------------------------------------------------------------------- Print Name: DOPAMINE 400MG IN DEXTROSE 5% Volume: 500 ML Print Name {2}: Synonyms: INTROPIN DOPAMINE D5 Generic Drug: DOPAMINE 400MG IN 5% DEXTROSE 500ML Pharmacy Orderable Item: DOPAMINE IN DEXTROSE 5% INJ,SOL Inactivation Date:


PreMix: YES End of Report

Example 2: User Selects all IV Solutions

Select Enhanced Order Checks Setup Menu Option: IV Solution Report

This report displays only those solutions in the IV Solutions (#52.7) File

that are marked as PreMix IV Solutions, or it displays all Solutions.


P Print only IV Solutions marked as PreMix

A Print All IV Solutions

Print report for PreMix (P), or All IV Solutions (A): (P/A): Premix: P// a Print All IV

Solutions




User Manual

Solution PreMix report for all IV Solutions Page: 1

------------------------------------------------------------------------------

Print Name: 0.9% SODIUM CHLORIDE Volume: 100 ML

Print Name {2}:

Synonyms: 2673

Generic Drug: SODIUM CHLORIDE 0.9% 100ML

Pharmacy Orderable Item: SODIUM CHLORIDE INJ

Inactivation Date:


PreMix:

Print Name: 0.9% SODIUM CHLORIDE Volume: 50 ML

Print Name {2}:

Synonyms: 2672

Generic Drug: SODIUM CHLORIDE 0.9% 50ML

Pharmacy Orderable Item: SODIUM CHLORIDE INJ

Inactivation Date:


PreMix:

Print Name: 20% DEXTROSE Volume: 500 ML

Print Name {2}:

Synonyms:

Generic Drug: DEXTROSE 20% IN WATER 500ML

Pharmacy Orderable Item: DEXTROSE INJ,SOLN

Inactivation Date:


PreMix:

Print Name: METRONIDAZOLE 500MG IN NACL Volume: 100 ML

Print Name {2}:

Synonyms:

Generic Drug: METRONIDAZOLE 500MG/100ML NACL

Pharmacy Orderable Item: METRONIDAZOLE/SODIUM CHLORIDE INJ,SOLN

Inactivation Date:


PreMix: YES

End of Report.

1.17.3 Mark PreMix Solutions [PSS MARK PREMIX SOLUTIONS]

The Mark PreMix Solutions [PSS MARK PREMIX SOLUTIONS] option allows a user to quickly

mark an IV Solution as a PreMix.

The following data fields can be edited:

• Print Name

• Print Name {2}

• Generic Drug

• Volume



• PreMix

After an entry has been edited successfully, the user is prompted to enter another IV Solution to

edit. Press <ENTER>, to exit out of the option.


User Manual

Example: User chooses Mark PreMix Solutions [PSS MARK PREMIX SOLUTIONS] to mark an IV Solution as premixed

Select IV Additive/Solution Option: MARK Select IV SOLUTIONS PRINT NAME: HEP

1 HEPARIN 1,000U/0.9% NS-2U/ML 500 ML 2 HEPARIN 25,000U/D5W (50U/ML) 250 ML

3 HEPARIN 25000 UNITS/0.45% NACL 250 ML CHOOSE 1-3: 3 HEPARIN 25000 UNITS/0.45% NACL 250 ML

PRINT NAME: HEPARIN 25000 UNITS/0.45% NACL Replace PRINT NAME {2}: GENERIC DRUG: HEPARIN 25,000 UNITS IN 0.45% NACL 250ML // VOLUME: 250 ML//

INACTIVATION DATE:

USED IN IV FLUID ORDER ENTRY: YES// PREMIX: YES//

1.18 Warning Builder [PSS WARNING BUILDER]

The Warning Builder [PSS WARNING BUILDER] option allows the user to print a copy of the

old and new warning file entries. The user can choose various ways to select drugs to review

which warnings will print when the flag is turned on to use the new warning label source. This

option also allows the user to override the default warning labels to create a custom warning

label list for the selected drug. This is accomplished by specifying a list of warning numbers

from the old RX CONSULT file (#54) and/or the new commercial data source warning file.

Example: Warning Builder [PSS WARNING BUILDER] Option

Select Pharmacy Data Management Option: WARNING BUilder

The RX CONSULT File (#54) contains local label expansions.

The WARNING LABEL-ENGLISH file (#50.625) contains national label

expansions in English.

The WARNING LABEL-SPANISH file (#50.626) contains national label

expansions in Spanish.

It is important to note that RX Consult entry numbers do not

correlate with the other files (i.e. Number 7 in file 54 is not

included in file 50.625).

You should print a list of the current RX CONSULT file entries

and the current WARNING LABEL-ENGLISH file entries.

Would you like to print a list of the entries in these files? N// YES

Would you like to include the Spanish translations? N// YES


DEVICE: HOME// COMPUTER ROOM

RX CONSULT file - WARNING LABEL TEXT

Date printed: JAN 18,2005 Page: 1

===============================================================================

RX CONSULT NUMBER: 1

-MAY CAUSE DROWSINESS-

Alcohol may intensify this effect.


User Manual

USE CARE when driving or

when operating dangerous machinery.

----------------------------------------------------------------------


IMPORTANT: Finish all this medication

unless otherwise directed by prescriber.

----------------------------------------------------------------------


Take medication on an EMPTY STOMACH

1 hour before or 2-3 hours after a

meal unless otherwise directed by

your doctor.

----------------------------------------------------------------------


Do not take antacids or iron

preparations or eat dairy products

within 1 hour of taking this medication.

----------------------------------------------------------------------


Take with plenty of WATER.

----------------------------------------------------------------------


May cause discolored urine or feces.

----------------------------------------------------------------------


It may be advisable to drink a full

glass of orange juice or eat a banana

daily while on this medication

----------------------------------------------------------------------


DO NOT DRINK ALCOHOLIC BEVERAGES

when taking this medication.

----------------------------------------------------------------------


DO NOT TAKE

non-prescription drugs

without medical advice.

----------------------------------------------------------------------


TAKE WITH FOOD OR MILK.

----------------------------------------------------------------------


Avoid prolonged exposure to SUNLIGHT

and finish all this medication

unless otherwise directed by prescriber.

----------------------------------------------------------------------


SHAKE WELL

----------------------------------------------------------------------


For external use ONLY.

----------------------------------------------------------------------


NOTE DOSAGE STRENGTH

----------------------------------------------------------------------


REFRIGERATE -DO NOT FREEZE


User Manual

----------------------------------------------------------------------


This prescription CANNOT be

refilled without a written

duplicate from your physician.

----------------------------------------------------------------------


Do not use after specified date.

----------------------------------------------------------------------


THIS PRESCRIPTION CANNOT BE REFILLED.

----------------------------------------------------------------------


This is the same medication you

have been getting. Color, size

or shape may appear different.

----------------------------------------------------------------------


CAUTION: Federal law prohibits the

transfer of this drug to any person

other than the patient for whom it

was prescribed.

Spanish translation:

PRECAUCION: La ley federal prohibe la transferencia de este medicamento

a otro paciente para el que no fue recetado.

----------------------------------------------------------------------

End of Rx Consult file Report.


WARNING LABEL-ENGLISH file - WARNING LABEL TEXT

Date printed: JAN 18,2005 Page: 1

===============================================================================

WARNING LABEL-ENGLISH NUMBER: 1

May cause drowsiness. Alcohol may intensify this

effect. Use care when operating a car or dangerous

machines.


Puede causar somnolencia. El alcohol puede intensificar

este efecto. Tenga cuidado cuando conduzca vehiculos

automotores u opere maquinaria peligrosa.

----------------------------------------------------------------------


Important: Finish all this medication unless

otherwise directed by prescriber.


Importante: Acabe todo este medicamento a menos que

quien le escriba la receta le indique lo contrario.

----------------------------------------------------------------------


Take medication on an empty stomach one hour before

or two to three hours after a meal unless otherwise

directed by your doctor.


Tome este medicamento con el estómago vacío una hora antes o dos a tres horas después de comer, a menos que


User Manual

su médico le indique lo contrario.

----------------------------------------------------------------------


Do not take dairy products, antacids, or iron

preparations within one hour of this medication.


Una hora antes de tomar este medicamento y hasta una

hora después de tomarlo, no tome productos lácteos,

antiácidos, o preparados de hierro.

----------------------------------------------------------------------


Medication should be taken with plenty of water.


Debe tomar este medicamento con mucha agua.

----------------------------------------------------------------------

.

.

.

This will print all warning labels in the commercial data source’s warning file.

(To save space, only the first five warning labels are displayed in this example.)

Select one of the following to display drugs that match that criteria to

examine or edit their drug warnings:

1. Drug has WARNING LABEL filled in but there are no FDB warnings for the drug

2. Drug has WARNING LABEL numbers higher than 20

3. Select by range of drug names

4. Drug has more than 5 warning labels

5. Drugs containing specific WARNING LABEL number

6. Drug has WARNING LABEL that does not map to new data source

7. Drugs containing specific new data source warning number

8. Drugs containing gender-specific warnings

9. Drugs with warning mapping, but drug doesn't contain "mapped to" number

Enter selection: // 4 GREATER THAN 5 WARNINGS

Exclude drugs with NEW WARNING LABEL LIST filled in? Y// <Enter> ES

NOTE: Only the first 5 warnings will print on the yellow auxillary labels.

Do you want to see the warning text for all warnings? Y// <Enter> ES

Warnings (>5) that won't print and won't be sent to CMOP

will be marked with a "*" on the following screens.

Current Warning labels for ACETAMINOPHEN AND CODEINE 30MG


1N May cause drowsiness. Alcohol may intensify this effect. Use care when

operating a car or dangerous machines.

62N May cause dizziness

45N Taking more of this medication than recommended may cause serious

breathing problems.


20 CAUTION: Federal law prohibits the transfer of this drug to any person

other than the patient for whom it was prescribed.

*66N This medicine contains ACETAMINOPHEN.Taking more ACETAMINOPHEN than


*70N Do not take other ACETAMINOPHEN containing products at the same time



User Manual

*14N Obtain medical advice before taking non-prescription

drugs as some may


Pharmacy fill card display: DRUG WARNING 1N,62N,45N,8N,20,66N,70N,14N




Current Warning labels for ALPRAZOLAM 0.25MG TABS


1N May cause drowsiness. Alcohol may intensify this effect. Use care when

operating a car or dangerous machines.

82N Warning: Do not use if you are pregnant, suspect that you are pregnant,

or while breastfeeding. Consult your doctor or pharmacist.

71N Do not eat grapefruit or drink grapefruit juice at any time while taking

this medication.

14N Obtain medical advice before taking non-prescription drugs as some may




*94N Herbal/dietary supplement products may interact with this medication.

Discuss any such product with your doctor or pharmacist before taking.

Pharmacy fill card display: DRUG WARNING 1N,82N,71N,14N,20,94N



Would you like to edit this list of warnings? N// YES

NEW WARNING LABEL LIST: 1,2,3N

Current Warning labels for ALPRAZOLAM 0.25MG TABS


1 -MAY CAUSE DROWSINESS- Alcohol may intensify this effect. USE CARE when

driving or when operating dangerous machinery.

2 IMPORTANT: Finish all this medication unless otherwise directed by

prescriber.

3N Take medication on an empty stomach one hour before or two to three hours

after a meal unless otherwise directed by your doctor.



Pharmacy fill card display: DRUG WARNING 1,2,3N,20

NEW WARNING LABEL LIST: 1,2,3N


1.19 Warning Mapping [PSS WARNING MAPPING]

The Warning Mapping [PSS WARNING MAPPING] option is used to match an entry from the

RX CONSULT file (#54) to the WARNING LABEL-ENGLISH file (#50.625) to aid in using

the Warning Builder [PSS WARNING BUILDER] option to identify local warnings that do not

have an equivalent entry in the commercial data source. The user can also enter a Spanish


User Manual

translation for an RX CONSULT file (#54) entry, if desired, but whenever possible, the

commercial data source’s warnings should be used.

Example: Warning Mapping [PSS WARNING MAPPING] Option

Select Pharmacy Data Management Option: WARNING MApping

Note: Warning mapping is only used as an aid when using the warning builder.

If a DRUG WARNING is defined with a warning mapping of 0, that entry will be

skipped when choosing option 6 Drug has WARNING LABEL that does not map to

new data source.


CURRENT WARNING MAPPING

DRUG WARNING Mapped to New data source number

1 DROWSINESS 1

2 FINISH 2

3 EMPTY STOMACH 3

4 NO DAIRY PRODUCTS 4

5 WATER 5

6 DISCOLORATION 6

7 DIURETIC K

8 NO ALCOHOL 8

9 ADVICE 9

10 WITH FOOD 10

11 SUNLIGHT 11

12 SHAKE WELL 19

13 EXTERNAL 20

14 STRENGTH

15 REFRIGERATE 30

16 DUPLICATE

17 EXPIRATION DATE

18 NO REFILL

19 SAME DRUG

20 NO TRANSFER

Enter a valid Rx Consult file number: 1 DROWSINESS

-MAY CAUSE DROWSINESS-

Alcohol may intensify this effect.

USE CARE when driving or

when operating dangerous machinery.

Rx Consult file number 1 is mapped to WARNING LABEL-ENGLISH number 1

May cause drowsiness. Alcohol may intensify this

effect. Use care when operating a car or dangerous

machines.

Do you want to change the mapping? N// y YES

WARNING MAPPING: 1// 8

Do not drink alcoholic beverages when taking this

medication.

Do you want to enter/edit a Spanish translation for this entry? N// <Enter> O

Enter a valid Rx Consult file number: 20 NO TRANSFER

CAUTION: Federal law prohibits the

transfer of this drug to any person

other than the patient for whom it

was prescribed.

Enter a number from WARNING LABEL-ENGLISH file to map to: : // 0

Do you want to enter/edit a Spanish translation for this entry? N// y YES


User Manual

SPANISH TRANSLATION: PRECAUCION: La ley federal prohibe la transferencia de este

medicamento a otro paciente para el que no fue recetado.

Enter a valid Rx Consult file number: <Enter>

1.20 Pharmacy Enterprise Product System (PEPS) Services

Menu [PSS PEPS Services]

The PEPS Services [PSS PEPS Services] sub-menu contains options that are used to check and

validate that the connection to the vendor database used for enhanced order checking (i.e., drug

interactions, duplicate therapy, and dosing) is enabled and operational. It also provides the ability

to execute various order checks to ensure that the database is installed properly and is reachable.

One option allows the scheduling of a background job, which monitors the connection to the

vendor database and notifies the user when the connection goes down.

This sub-menu contains the following options:

• Check Vendor Database Link

• Check PEPS Services Setup

• Schedule/Reschedule Check PEPS Interface

1.20.1 Check Vendor Database Link [PSS CHECK VENDOR DATABASE LINK]

The Check Vendor Database Link [PSS CHECK VENDOR DATABASE LINK] option allows

you to check whether VistA can or cannot communicate with the vendor database. If the

communication link is up and running, the vendor database version, build version and date it was

issued will be displayed for both standard and custom databases. Standard data is as received

from the vendor, while custom data is modified standard or new data provided by the VA. The

date and time of the connection will also display.

If the connection could not be made, this status is displayed with the date and time a successful

connection was last made. The Domain Name Service (DNS) for the MOCHA server now

displays with Patch PSS*1*173.

Example 1: Successful Connection Made to Vendor Database

Select Pharmacy Data Management Option: PEPS Services

Select PEPS Services Option: CHECK VENDOR Database Link

Database Version: 6

Build Version: 3.2

Issue Date: 01/29/2010

Custom Database Version: 6

Custom Build Version: 3.2

Custom Issue Date: 08/07/2009

Connected to MOCHA2-PRE.R01.PHARMACY.HEALTHEVET.VA.GOV successfully @FEB 22, 2010@16:31


User Manual


Select PEPS Services Option:

Note: If no data has been installed in the custom table, the connection check returns

“Unavailable” for all three fields, as shown below:

CHOOSE 1-2: 2 Check Vendor Database Link

Database Version: 7

Build Version: 3.2

Issue Date: 06/04/2010

Custom Database Version: NOT AVAILABLE

Custom Build Version: NOT AVAILABLE

Custom Issue Date: NOT AVAILABLE

Connected to MOCHA2-PRE.R01.PHARMACY.HEALTHEVET.VA.GOV successfully @AUG 12, 2010@09:05


Note: The above example could also happen to standard tables as well.

Example 2: Connection Could Not Be Made to Vendor Database:

Select PEPS Services Option: CHECK Vendor Database Link

Connection could not be made to MOCHA2-PRE.R01.PHARMACY.HEALTHEVET.VA.GOV.

Last reached @OCT 25, 2010@14:52


1.20.2 Check PEPS Services Setup [PSS CHECK PEPS SERVICES SETUP]

The Check PEPS Services Setup [PSS CHECK PEPS SERVICES SETUP] option provides the

ability to check and validate that the link to the vendor interface used for enhanced order

checking (drug interaction, duplicate therapy, and dosing) is enabled and operational. The option

executes various predetermined order checks against the vendor database to ensure that the

database is installed correctly and is reachable.

A device can be entered in the Select Device field. If a device is not entered, then the job

will display on the screen.

Example 1: Vendor Database Reachable; Enhanced Order Checks Executed.

<CPM> Select PEPS Services Option: CHECK

1 Check PEPS Services Setup

2 Check Vendor Database Link

CHOOSE 1-2: 1 Check PEPS Services Setup

This option performs several checks. You may queue this report if you wish.

Among these checks are:

-----------------------


User Manual

A connection check to the Vendor Database

Drug-Drug Interaction Check

Duplicate Therapy Order Check

Dosing Order Check

Custom Drug-Drug Interaction Check

Select Device: HOME// <ENTER> COMPUTER ROOM

Checking Vendor Database Connection...OK

Type <Enter> to continue or '^' to exit:Performing Drug-Drug Interaction Order Check for

CIPROFLOXACIN HCL 250MG TAB

and WARFARIN NA (GOLDEN STATE) 5MG TAB...OK

Critical Drug Interaction: Concurrent use of quinolones may increase the

hypoprothrombinemic effects of anticoagulants, which may result in an

increased risk of bleeding.

Type <Enter> to continue or '^' to exit:Performing Duplicate Therapy Order Check for

CIMETIDINE 300MG TAB and

RANITIDINE 150MG TAB...OK

Therapeutic Duplication with CIMETIDINE 300MG TAB and RANITIDINE 150MG TAB

Duplicate Therapy Class(es): Peptic Ulcer Agents,Histamine-2 Receptor

Antagonists (H2 Antagonists)

Type <Enter> to continue or '^' to exit:Performing Dosing Order Check for ACETAMINOPHEN 500MG

TAB - 3000MG Q4H...OK

Single dose amount of 3,000 MILLIGRAMS exceeds the maximum single dose amount

of 1,000 MILLIGRAMS.

Total dose amount of 18,000 MILLIGRAMS/DAY exceeds the maximum daily dose

amount of 4,000 MILLIGRAMS/DAY.

Type <Enter> to continue or '^' to exit:

Performing Custom Drug-Drug Interaction Order Check for CLARITHROMYCIN 250MG

TAB and DIAZEPAM 5MG TAB...OK

Significant Drug Interaction: Serum concentrations of certain benzodiazepines may be increased enhancing their pharmacological effects. Toxic effects of increased benzodiazepine levels include profound sedation,respiratory depression, coma, and/or death.

Type <Enter> to continue or '^' to exit:

Example 2: Vendor database unreachable; enhanced order checks cannot be executed.

Select PEPS Services Option: check

1 Check PEPS Services Setup

2 Check Vendor Database Link

CHOOSE 1-2: 1 Check PEPS Services Setup

Checking Vendor Database Connection...

Connection could not be made to Vendor database.

Last reached @MAR 02, 2010@11:44


1.20.3 Schedule/Reschedule Check PEPS Interface [PSS SCHEDULE PEPS INTERFACE CK]

The Schedule/Reschedule Check PEPS Interface [PSS SCHEDULE PEPS INTERFACE CK]

option allows you to schedule the Interface Scheduler [PSS INTERFACE SCHEDULER] option,

which tests the PEPS interface by sending a PING request. If the PEPS Interface is not available,

a mail message will be sent to the G.PSS ORDER CHECKS mail group. This must be scheduled


User Manual

so constant monitoring takes place on the Mocha Interface, to provide timely notification of any

problems.

Please note that the next paragraph regarding the POSTMASTER is only applicable up until the

installation of patch PSS*1.0*163, because PSS*1.0*163 includes functionality that will replace

any Person’s Internal Entry Number in the interface message that is not a whole number with the

number 0 , because the interface will accept 0 as a valid number. PSS*1.0*163 will also do the

same with Job Number, and Station Number (after stripping off any non-numeric characters).

This conversion will also happen on all Order Check messages.

When scheduling this job, the person that is doing the scheduling must NOT have assumed the

identity of the POSTMASTER, because the Internal Entry Number of the POSTMASTER is .5,

and the decimal could cause the interface to fail, so this job would continue to fail until it is

scheduled by another user other than POSTMASTER.

IMPORTANT: A device must be entered in the DEVICE FOR QUEUED JOB OUTPUT field. If a

device is not entered, then the job can result in a failure, generating the mail message

indicating the Order Check system is not available, when the system really was never

unavailable. Most sites have a “NULL” type entry in the DEVICE (#3.5) File, as that is

the recommended device, since the tasked job does not write any data. Additionally, it is recommended that “Startup Persistent” be entered in the SPECIAL QUEUING field.

This will queue the job to run whenever the TaskMan/computer is started (i.e., at

System Boot), and will restart the task if it stops unexpectedly. If this type of restart

does occur, the task could be set by Kernel to be run by POSTMASTER, which as

stated in the previous paragraph could cause the job to fail. If this occurs, then someone

would need to reschedule the job, with the identity of any user besides POSTMASTER. Also as stated a few paragraphs earlier, this POSTMASTER issue is resolved by patch

PSS*1.0*163, by replacing .5 with a 0 in the interface message.

To check the link, start up the PEPS Services Option Menu [PSS PEPS SERVICES].

Check Vendor Database Link

Check PEPS Services Setup

Schedule/Reschedule Check PEPS Interface


Select PEPS Services Option: Schedule/Reschedule Check PEPS Interface

Edit Option Schedule

Option Name: PSS INTERFACE SCHEDULER

Menu Text: Interface Scheduler TASK ID: 892595

__________________________________________________________________________

QUEUED TO RUN AT WHAT TIME: JAN 23,2011@14:25:41

DEVICE FOR QUEUED JOB OUTPUT: NULL DEVICE;P-DEC;80;64

QUEUED TO RUN ON VOLUME SET:

RESCHEDULING FREQUENCY: 900S

TASK PARAMETERS:

SPECIAL QUEUEING: Startup Persistent

_______________________________________________________________________________

Exit Save Next Page Refresh

Enter a command or '^' followed by a caption to jump to a specific field.


User Manual

COMMAND: Press <PF1>H for help Insert

1.20.4 Print Interface Data File [PSS SCHEDULE PEPS INTERFACE CK]

The Print Interface Data File [PSS SCHEDULE PEPS INTERFACE CK] option allows you to

print a report from the VENDOR INTERFACE DATA file (#59.74) which keeps track of when

and for how long the vendor interface is unavailable while a background process monitors the

status of the interface and records in this file when the interface is down, when it becomes

available again, and the total time it was unavailable. You are asked for a date/time range so that

the report can then be sorted by the most recent downtime first and then provided a SELECT

DEVICE PROMPT for the printing/displaying of the report.

Example: Print Interface Data File [PSS SCHEDULE PEPS INTERFACE CK] Option





<CPM> Select PEPS Services Option: PRint Interface Data File

This report will print out all information related to when and for how long the

vendor interface is unavailable (sorted by most recent down time first).

This information comes from the VENDOR INTERFACE DATA FILE.

*** This has the potential to be a long report ***

You may queue the report to print if you wish. You may also "^" to halt the

report at any time.

START WITH DATE/TIME VENDOR UNAVAILABLE: FIRST// 3.18.11 (MAR 18, 2011)

GO TO DATE/TIME VENDOR UNAVAILABLE: LAST// T (MAY 18, 2011)

DEVICE: QUEUE TO PRINT ON

DEVICE: REX REX$PRT Printer Alley

Requested Time To Print: NOW// <Enter> (MAY 18, 2011@11:30)

REQUEST QUEUED!

Task number: 3469591





<CPM> Select PEPS Services Option:

If the PEPS Interface is down, a priority mail message will be sent to the G.PSS ORDER

CHECKS mail group. When the interface is back up again, another priority mail message will be

sent to the G. PSS ORDER CHECKS mail group. Only one message per occurrence (interface

being down or coming back up) is sent because the background job runs every 15 minutes.

Here is an example of the mail message when the database is down:

Subj: ORDER CHECK DATABASE DOWN [#55252] 03/02/10@11:59 2 lines

From: PSS INTERFACE SCHEDULER In 'IN' basket. Automatic Deletion Date: Mar 30, 2010


User Manual

--------------------------------------------------------------------------------Connection to

Vendor Database is down! No Drug-Drug Interactions, Duplicate

Therapy or Dosing Order Checks will be performed until the connection is reestablished!!!


Here is an example of the mail message when the database is back up:

Subj: ORDER CHECK DATABASE IS BACK UP [#57254] 08/15/10@02:44 2 lines

From: PSS INTERFACE SCHEDULER In 'IN' basket.

Automatic Deletion Date: Aug 18, 2010 Page 1 Priority!

-------------------------------------------------------------------------------

Connection to Vendor Database has been restored! Drug-Drug Interactions,

Duplicate Therapy and Dosing Order Checks can now be performed.


1.21 Inpatient Drug Management [PSS INP MGR]

Patch PSS*1*146 corrected a patient safety issue in which editing the IV ADDITIVES file

(#52.6) and/or IV SOLUTIONS file (#52.7) using the Drug Enter/Edit [PSS DRUG

ENTER/EDIT] option was problematic. The functionality was changed to prevent erroneous

matching with Dispense Drugs.

The software now gives the user the choice to enter and link the dispense drug to a new Additive

or Solution as well as a confirmation of the selected dispense drug that will be linked to the

selected additive/solution.

The Inpatient Drug Management [PSS INP MGR] sub-menu contains the following options:

• ADditives File

• Dispense Drug Fields

• Dispense Drug/ATC Set Up

• Edit Cost Data

• EDit Drug Cost (IV)

• MARk/Unmark Dispense Drugs For Unit Dose

• PRimary Solution File (IV)

1.21.1 ADditives File [PSSJI DRUG]

This option allows the applications coordinator to add, change, or inactivate drugs that are to be

used as additives in the IV room. All drug information is contained within the IV ADDITIVES

file (#52.6).

To avoid confusion when users are linking an IV Additive to a Generic Drug at the GENERIC

DRUG prompt in menu option ADditives File [PSSJI DRUG], the option now clearly shows

which is the IV Additive and which is the Generic Drug.


User Manual

Example: IV Additive and Generic Drug

PRINT NAME: CEFAZOLIN//

GENERIC DRUG: CEFAZOLIN SOD 10GM M/D INJ// CEFAZ

1 CEFAZOLIN OPTH SOLN 50MG/CC (15CC)

2 CEFAZOLIN SOD 10GM M/D INJ AM115

3 CEFAZOLIN SOD 1GM INJ AM115 N/F

CHOOSE 1-3: 3 CEFAZOLIN SOD 1GM INJ AM115 N/

You are about to change the GENERIC DRUG linked to this ADDITIVE.

ADDITIVE CEFAZOLIN is currently linked to

GENERIC DRUG CEFAZOLIN SOD 10GM M/D INJ.

Are you sure you want to link ADDITIVE CEFAZOLIN

to GENERIC DRUG CEFAZOLIN SOD 1GM INJ? No//

PSS*1*174 resolved the issue of ambiguous IV Additive strength when a pharmacist is finishing

an IV by adding a STRENGTH (#19) field to the IV ADDITIVES File (#52.6). The new

STRENGTH (#19) field can be populated when adding a new IV Additive or when editing

an existing IV Additive via menu option ADditives File [PSSJI DRUG].

Example: Added Strength Field

PRINT NAME: CEFAZOLIN//

GENERIC DRUG: CEFAZOLIN SOD 10GM M/D INJ// AM115

USED IN IV FLUID ORDER ENTRY: YES//

DRUG UNIT: GM//

STRENGTH: 1// ??

This field identifies the numeric amount of medication that is provided by one unit-of-use

for the identified product.

For example, if one vial contains 50 MG of medication, the STRENGTH will be entered as '50'.

The DRUG UNIT of 'MG' is populated by the DRUG UNIT (#2) field.

Whenever a lookup is performed on the IV ADDITIVES File (#52.6), the STRENGTH (#19)

field will display next to the NAME (#.01) field with the words "Additive Strength:" and then its

value. Additionally, the DRUG UNIT (#2) field will be appended to the STRENGTH (#19) field.

If the STRENGTH (#19) field is not populated for the IV Additive, the text "N/A" will display,

and the DRUG UNIT (#2) field will not display.

Example: Additive Strength Field (continued)

Select IV TYPE: PIGGYBACK.

Select ADDITIVE: CEFAZOL

1 CEFAZOLIN Additive Strength: 1 GM

IV ROOM ONLY


3 CEFAZOLIN PREMIX Additive Strength: N/A

CHOOSE 1-3:

Quick Codes are displayed during the selection of an IV ADDITIVE during order entry. When a

lookup is performed on an IV ADDITIVE, and there are QUICK CODES defined for the IV

ADDITIVE, the QUICK CODE STRENGTH (#1) field and the USUAL IV SCHEDULE (#4)

field from the QUICK CODE Subfile (#52.61) will display next to the QUICK CODE. If the

QUICK CODE STRENGTH (#1) field is null, "N/A" will be displayed. If the USUAL IV

SCHEDULE (#4) field is null, "N/A" will be displayed.


User Manual

Example: Display of Quick Codes

Select ADDITIVE: CEFAZ


- CEFAZ1GM - Quick Code Strength: 1 GM Schedule: N/A

- CEFAZ2GM - Quick Code Strength: N/A Schedule: BID


IV ROOM ONLY

3 CEFAZOLIN PREMIX Additive Strength: N/A

CHOOSE 1-3:

PSS*1*174 also enhanced the capabilities of the IV ADDITIVES File (#52.6) so that a user can

enter a new additive that has the same name as an existing entry. Previously, a Fileman

workaround had to be used to enter an identically named entry. Now, if the user types in a name

that already exists in the file, they will first be presented with a list of available selections. If the

user scrolls through the list without selecting an entry, they will be presented with the prompt to

add a new entry.

For example - IV ADDITIVES File (#52.6)

CHOOSE 1-2: 1 PSSJI DRUG ADditives File

ADditives File

Select IV ADDITIVES PRINT NAME: TESTDRUG

Lookup: PRINT NAME

1 TESTDRUG Additive Strength: 10 MG

2 TESTDRUG Additive Strength: N/A



CHOOSE 1-4:

Are you adding 'TESTDRUG' as a new IV ADDITIVES (the 77TH)? No// Y

(Yes)

Patch PSS*1*189 enhances the Additives File [PSSJI DRUG] option to display the

INACTIVATION DATE field (#12) for the IV ADDITIVES file (52.6).

1.21.2 Dispense Drug Fields [PSSJU DRG]

This option allows the user to enter data into fields that are used as default values, and in

calculating default values, when the drug is chosen in Unit Dose ORDER ENTRY. This option

allows the selection of any drug, including INACTIVE or NON-FORMULARY items.

1.21.3 Dispense Drug/ATC Set Up [PSSJU DRUG/ATC SET UP]

This allows the user to edit the drug fields necessary to send drugs to ATC Unit Dose dispensing

machine. In order for a drug to be sent to the ATC, the drug must have a CANISTER NUMBER

for each ward group that will be sending a pick list to the ATC, and the drug must also have a

MNEMONIC.


User Manual

1.21.4 Edit Cost Data [PSSJU DCC]

Allows the user to edit the dispensing cost data used for the cost reports. If any data is changed, a

MailMan message is sent to all users holding the PSJU MGR security key (supervisors).

1.21.5 EDit Drug Cost (IV) [PSSJI EDIT DRUG COST]

This menu option allows the cost per unit to be entered for drugs (both additives and solutions).

1.21.6 MARk/Unmark Dispense Drugs For Unit Dose [PSSJU MARK UD ITEMS]

This allows users to easily mark or unmark items from the Drug file (#50)for use by the Unit

Dose Medications package. Only those items marked for Unit Dose are selectable for Unit Dose

orders. When the Inpatient Medications package is first installed, it marks all items in the DRUG

file (#50) for use by Unit Dose so that users may immediately continue to use the package. This

can be used to unmark those dispense items that Unit Dose users should not be able to select.

1.21.7 PRimary Solution File (IV) [PSSJI SOLN]

This option is for the applications coordinator to add, change, or inactivate primary solutions

used in the IV section. The solution must already exist in the DRUG file (#50) to be selected

here. If use of a primary solution is to be discontinued, the solution should be inactivated by

entering an inactivation date, rather than by deleting the solution from the file.

PSS*1*174 enhanced the capabilities of the IV SOLUTIONS File (#52.7) so that a user can enter

a new solution that has the same name as an existing entry. Previously, a Fileman workaround

had to be used to enter an identically named entry. Now, if the user types in a name that already

exists in the file, they will first be presented with a list of available selections. If the user scrolls

through the list without selecting an entry, they will be presented with the prompt to add a new

entry.

Example: IV SOLUTIONS File (#52.7)

Select OPTION NAME: PSSJI SOLN PRimary Solution File (IV)

PRimary Solution File (IV)

Select IV SOLUTIONS PRINT NAME: 0.9% SODIUM CHLORIDE

Lookup: PRINT NAME




CHOOSE 1-3:

Are you adding '0.9% SODIUM CHLORIDE' as

a new IV SOLUTIONS (the 32ND)? No// Y (Yes)


User Manual

Patch PSS*1*189 enhances the Primary Solution File (IV) [PSSJI SOLN] option to display the

INACTIVATION DATE field (#8) for the IV SOLUTIONS file (52.7).

IV solutions matched to an Orderable item will now be governed by the following rule (patch

PSS*1*189):

An Orderable Item can only have ONE IV solution with a specific volume when it is marked to

be used in the IV Order Dialog. When adding a new item to an Orderable item the volume for the

new item must follow the above rule or an error message will display as shown in the example

below:

Example:

PRINT NAME: NACL 0.9%/KCL 40MEQ Replace

PRINT NAME {2}:

GENERIC DRUG: POTASSIUM CL 40MEQ/NACL 0.9% INJ,1000 ML// TN102

VOLUME: 1000 ML//

Select ELECTROLYTES:

Select SYNONYM: 0.9% SODIUM CHLORIDE 40MEQ//

DRUG INFORMATION:

No existing text

Edit? NO//

AVERAGE DRUG COST: .01//

INACTIVATION DATE:

USED IN IV FLUID ORDER ENTRY: NO// YES

The following IV Solution with the same volume is already linked to the

Orderable Item SODIUM CHLORIDE 0.9%

Dispense Drug: POTASSIUM CL 20MEQ/NACL 0.9% INJ,1000 ML

IV Solution: NACL 0.9%/KCL 20MEQ 1000 ML

Only one IV solution with a specific volume can be linked to an

Orderable Item when the IV Solution is marked to be used in the IV FLUID

ORDER ENTRY.

USED IN IV FLUID ORDER ENTRY: NO//

PREMIX:

1.22 Check Drug Interaction [PSS CHECK DRUG INTERACTION]

The Check Drug Interaction [PSS CHECK DRUG INTERACTION] option is a new option that

shall be provided to allow a user to check for drug interaction and Therapeutic Duplications

between two or more drugs. This option shall be patient independent. This option shall be placed

on the PDM Manager [PSS MGR] Menu. The drugs shall be selectable from the DRUG file

(#50). The system will allow selection of drugs marked for application package use O, U, I,

and/or X. The system will only allow selection of drugs that are matched to NDF and have a

GCNSEQNO associated with that match. The software shall check for values in the FDB custom

tables before using the FDB standard reference tables. The values in the custom tables shall take

precedence over the values in the standard tables.

Example: Check Drug Interaction [PSS CHECK DRUG INTERACTION] Option

Select PHARMACY DATA MANAGEMENT Option:

CMOP Mark/Unmark (Single drug)

Dosages ...


User Manual

Drug Enter/Edit

Order Check Management ...


Lookup into Dispense Drug File

Medication Instruction Management ...

Medication Routes Management ...

Orderable Item Management ...

Formulary Information Report

Drug Text Management ...

Pharmacy System Parameters Edit

Standard Schedule Management ...

Synonym Enter/Edit

Controlled Substances/PKI Reports ...


IV Additive/Solution ...

Warning Builder

Warning Mapping

PEPS Services ...

Check Drug Interaction

Select PHARMACY DATA MANAGEMENT Option: Check Drug Interaction

Drug 1: SIMVASTATIN 40MG TAB CV350

...OK? Yes// (Yes)

Drug 2: WARFARIN 1MG TAB


WARFARIN 1MG TAB BL110

...OK? Yes// (Yes)

Drug 3:

Now Processing Enhanced Order Checks! Please wait...

*** DRUG INTERACTION(S) ***

============================================================

***Significant*** with SIMVASTATIN 40MG TAB and

WARFARIN 1MG TAB

CLINICAL EFFECTS: Increase hypoprothrombinemic effects of warfarin.

============================================================

Press Return to Continue...:

Display Professional Interaction monograph? N// YES

DEVICE: HOME// SSH VIRTUAL TERMINAL Right Margin: 80//

------------------------------------------------------------

Professional Monograph

Drug Interaction with SIMVASTATIN 40MG TAB and WARFARIN 1MG TAB

This information is generalized and not intended as specific medical

advice. Consult your healthcare professional before taking or

discontinuing any drug or commencing any course of treatment.

MONOGRAPH TITLE: Selected Anticoagulants/Selected HMG-CoA Reductase

Inhibitors

SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the

patient and take action as needed.

MECHANISM OF ACTION: The exact mechanism of this interaction is

unknown. The HMG-CoA reductase inhibitor may inhibit the hepatic

hydroxylation of warfarin. The HMG-CoA reductase inhibitors, which

are highly plasma protein bound, may displace warfarin from its

binding site.



User Manual


CLINICAL EFFECTS: Increase hypoprothrombinemic effects of warfarin.

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: Patients should be monitored for changes in

prothrombin time when a HMG Co-A reductase inhibitor is added to or

discontinued from warfarin therapy, or if the dosage of the HMG Co-A

reductase inhibitor is adjusted.

DISCUSSION: Case reports in the medical literature and to the

manufacturer have documented an interaction between lovastatin and

warfarin. A case report has documented an interaction between

pravastatin and fluindione (an orally administered indanedione

anticoagulant), suggesting that pravastatin could also interact

similarly with warfarin. Information concerning a potential

interaction with simvastatin is conflicting. A case report has

documented an interaction between simvastatin and acenocoumarol while

another case report showed no interaction with warfarin. One group of

authors reported three case reports of increased international

normalized ratios (INRs) following the addition of fluvastatin to

warfarin therapy. The addition of rosuvastatin to patients stabilized

on warfarin resulted in clinically significant changes in INR.



REFERENCES:

1.Ahmad S. Lovastatin. Warfarin interaction. Arch Intern Med 1990 Nov;

150(11):2407.

2.Hoffman HS. The interaction of lovastatin and warfarin. Conn Med

1992 Feb; 56(2):107.

3.Iliadis EA, Konwinski MF. Lovastatin during warfarin therapy

resulting in bleeding. Pa Med 1995 Dec;98(12):31.

4.Personal communication. Merck & Co., Inc. 1991.

5.Trenque T, Choisy H, Germain ML. Pravastatin: interaction with oral

anticoagulant?. BMJ 1996 Apr 6;312(7035):886.

6.Grau E, Perella M, Pastor E. Simvastatin-oral anticoagulant

interaction. Lancet 1996 Feb 10;347(8998):405-6.

7.Gaw A, Wosornu D. Simvastatin during warfarin therapy in

hyperlipoproteinaemia. Lancet 1992 Oct 17;340(8825):979-80.

8.Trilli LE, Kelley CL, Aspinall SL, Kroner BA. Potential interaction

between warfarin and fluvastatin. Ann Pharmacother 1996 Dec;

30(12):1399-402.



9.Crestor (rosuvastatin calcium) US prescribing information.

AstraZeneca Pharmaceuticals LP February, 2012.

Copyright 2012 First DataBank, Inc.

------------------------------------------------------------

Display Professional Interaction monograph? N// O

1.23 Infusion Instruction Management [PSS INFINS MGR]

The Infusion Instruction Management [PSS INFINS MGR] menu contains the following options:

• Infusion Instructions Add/Edit

• Infusion Instructions Report


User Manual

1.23.1 Infusion Instructions Add/Edit [PSS INFINS ADED]

The Infusion Instructions Add/Edit [PSS INFINS ADED] option allows the entry and editing of

abbreviations and expansions in the INFUSION INSTRUCTIONS (#53.47) file. When entered

into the Infusion Rate field during the entry of inpatient medication orders, Infusion Instruction

abbreviations are replaced with the expanded text associated with the abbreviation.

Example: Infusion Instructions Add/Edit [PSS INFINS ADED] Option

Select Infusion Instruction Management Option: Infusion Instructions Add/Edit

Select INFUSION INSTRUCTIONS NAME: T1

Are you adding 'T1' as a new INFUSION INSTRUCTIONS (the 14TH)? No// Y (Yes)

INFUSION INSTRUCTIONS EXPANSION: TEST ONE

Select INFUSION INSTRUCTIONS NAME:

1.23.2 Infusion Instructions Report [PSS INFINS RPT]

Provides a report of entries from the INFUSION INSTRUCTIONS file (#53.47).

Example: Infusion Instructions Report [PSS INFINS RPT] Option

Select Infusion Instruction Management <TEST ACCOUNT> Option: Infusion Instructions Report

This report displays entries from the INFUSION INSTRUCTION (#53.47) File.


80 80 Column

132 132 Column

Print report in 80 or 132 column format: 80// Column

DEVICE: HOME// SSH VIRTUAL TERMINAL Right Margin: 80//

INFUSION INSTRUCTION FILE REPORT PAGE: 1

-----------------------------------------------------------------------------

T1 EXPANSION: TEST ONE

TEST EXPANSION: TEST

End of Report.


1.24 Stand-Alone Menu Options

This section describes the stand-alone menu options that are not exported as part of the main

menu.


User Manual

1.24.1 Enable/Disable Vendor Database Link [PSS ENABLE/DISABLE DB LINK]

The Enable/Disable Vendor Database Link [PSS ENABLE/DISABLE DB LINK] option is a

stand-alone option that exists ONLY as a way for technical personnel to turn on/off the database

connection if required for debugging. When disabled, NO drug-drug interactions, duplicate

therapy, or dosing order checks will be performed in Outpatient Pharmacy, Inpatient Medication

applications, or in the Computerized Patient Record System (CPRS).

Normally the link is enabled and the Vendor Database updates are performed centrally at the

Austin Information Technology Center (AITC) and Philadelphia Information Technology Center

(PITC).

The option is rarely used. It is NOT exported as part of the main Pharmacy Data Management

[PSS MGR] menu option. The examples provided are for technical personnel only.

Example 1: Disabling the Vendor Database Link

Select OPTION NAME: PSS ENABLE/DISABLE DB LINK Enable/Disable Vendor Database Link


The connection to the Vendor database is currently ENABLED.

Do you wish to DISABLE the connection to the Vendor database? NO//y Yes

NO Drug-Drug Interactions, Duplicate Therapy or Dosing Order Checks will be performed while

the connection is disabled!!!

Are you sure you want to DISABLE the connection to the Vendor Database? NO//y Yes

Vendor database connection DISABLED.

REMEMBER to ENABLE the Vendor database connection AFTER task completed.


Example 2: Enabling the Vendor Database Link

Select OPTION NAME: PSS ENABLE/DISABLE DB LINK Enable/Disable Vendor Database Link


WARNING: The connection to the Vendor database is currently DISABLED.

NO Drug-Drug Interactions, Duplicate Therapy or Dosing Order Checks will be performed while

the connection is disabled!!!

Do you wish to ENABLE the connection to the Vendor database? YES//y Yes

Vendor database connection ENABLED.

Connected to Vendor database successfully.


1.24.2 Other Language Translation Setup [PSS OTHER LANGUAGE SETUP]


User Manual

This is a stand-alone menu option that is not exported with the main menu. The Other Language

Translation Setup [PSS OTHER LANGUAGE SETUP] option provides the ability to enter/edit

data in the PHARMACY SYSTEM file (#59.7). This option allows sites to enter appropriate

terms in another language that make up parts of the SIG when printing prescription bottle labels.

If the user does not enter a translation, the English word will print. The Other Language

Translation Setup [PSS OTHER LANGUAGE SETUP] option is a stand-alone option that must

be assigned to the person(s) responsible for maintaining it. See Appendices C-G for lists of

Spanish equivalents for some of the more common terms used for administration schedules,

dosage forms, local possible dosages, medication instructions, and medication routes.

Example: Other Language Translation Setup [PSS OTHER LANGUAGE SETUP] Option

USE OF ANOTHER LANGUAGE: YES <If No is entered the remaining fields will not be prompted for

SECONDS: SEGUNDOS

MINUTES: MINUTOS

DAYS: DIAS

WEEKS: SEMANAS

HOURS: HORAS

MONTHS: MESES

AND: Y

THEN: LUEGO

EXCEPT: EXCEPTO

ONE: UNA

TWO: DOS

THREE: TRES

FOUR: CUATRO

FIVE: CINCO

SIX: SEIS

SEVEN: SIETE

EIGHT: OCHO

NINE: NUEVE

TEN: DIEZ

ONE-HALF: MEDIA

ONE-FOURTH: UN-CUARTO

ONE-THIRD: UN-TERCIO

TWO-THIRDS: DOS-TERCIOS

THREE-FOURTHS: TRES-CUARTOS

FOR: POR

1.24.3 Find Unmapped Local Possible Dosages [PSS LOCAL DOSAGES EDIT ALL]

A new option called Find Unmapped Local Possible Dosages [PSS LOCAL DOSAGES EDIT

ALL] is provided to identify all Local Possible Dosages that are eligible for dosage checks and

do not have either the Numeric Dose or Dose Unit populated.

Drugs with the following criteria will be screened out from this option.

• Inactive

• Not Matched to NDF

• Associated with dosage form that is excluded from dosage checks and matched to a VA

Product that has the OVERRIDE DF DOSE CHK EXCLUSION field (#31) set to ‘No’

• Associated with dosage form that is NOT excluded from dosage checks, but is matched

to a VA Product that has the OVERRIDE DF DOSE CHK EXCLUSION field (#31) set

to ‘Yes’


User Manual

• Drug is marked as a supply item (‘S’ in DEA, SPECIAL HDLG field (#3) or assigned a

VA Drug Class starting with an ‘XA’)

• Drug does not have any Local Possible Dosages defined

All identified drugs, along with their Local Possible Dosages will be presented to the user one by

one for editing. If data exists in the strength and unit fields for the drug, it will be displayed

following the drug name. The user will be notified if the strength defined for the drug does not

match the strength of the VA Product that it is matched to. The strength and unit of the VA

Product the drug is matched to will be displayed along with the strength in the DRUG file (#50).

Next, the first Local Possible Dosage defined for the selected drug will be displayed. The user

will be prompted to enter a Dose Unit, followed by the Numeric Dose. The Dose Unit will be

selectable from the new DOSE UNITS file (#51.24).

Any data entered will be redisplayed to the user (Local Possible Dosage, Dose Unit and Numeric

Dose) before presenting the next Local Possible Dosage for editing, if one exists for the drug. All

Local Possible Dosages defined for the drug with missing data in the NUMERIC DOSE sub-

field (#5) of the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50) and DOSE

UNIT sub-field (#4) of the LOCAL POSSIBLE DOSAGES multiple (#904) in DRUG file (#50)

will be presented for editing.

Example: Find Unmapped Local Possible Dosages [PSS LOCAL DOSAGES EDIT ALL] Option

Select Enhanced Order Checks Setup Menu Option: Find Unmapped Local Possible Dosages

This option will find all Local Possible Dosages that are eligible for Dosage

Checks that do not have either the Numeric Dosage or Dose Unit entered for the

Local Possible Dosage. This mapping is necessary to perform Dosage checks.

Searching for local Possible Dosages...

Drug: ACETAMINOPHEN ELIX. 120MG/5ML 4OZ



Please Note: Strength of drug does not match strength of VA Product it is

matched to.

TWO TEASPOONFULS

Numeric Dose: Dose Unit: MILLIGRAM(S)

DOSE UNIT: MILLIGRAM(S)// <ENTER>

NUMERIC DOSE: 240

TWO TEASPOONFULS


Drug: ACETAMINOPHEN 120MG/COD 12MG PER 5ML EL

TWO TEASPOONFULS

DOSE UNIT: TEASPOONFUL(S)

NUMERIC DOSE: 2

TWO TEASPOONFULS

Numeric Dose: 2 Dose Unit: TEASPOONFUL(S)


User Manual

ONE TABLESPOONFUL

DOSE UNIT: TABLESPOONFUL(S)

NUMERIC DOSE: 1

ONE TABLESPOONFUL

Numeric Dose: 1 Dose Unit: TABLESPOONFUL(S)

Drug: ALBUMIN 25% INJ BL500

Strength: 25 Unit: %

50 ML

DOSE UNIT: GRAM(S)

NUMERIC DOSE: 12.5

50 ML

Numeric Dose: 12.5 Dose Unit: GRAM(S)

100 ML

DOSE UNIT: GRAM(S)

NUMERIC DOSE: 25

100 ML

Numeric Dose: 25 Dose Unit: GRAM(S)

Drug: ALBUTEROL SO4 0.083% INHL 3ML RE102


1 AMPULE

DOSE UNIT: MILLILITER(S)

NUMERIC DOSE: 3

1 AMPULE

Numeric Dose: 3 Dose Unit: MILLILITER(S)

Drug: ALBUTEROL 90/IPRATROP 18MCG 200D PO INHL

TWO PUFFS

DOSE UNIT: INHALATION(S)

NUMERIC DOSE: 2

TWO PUFFS

Numeric Dose: 2 Dose Unit: INHALATION(S)

Drug: AMLODIPINE 10MG/VALSARTAN 320MG TAB

1 TABLET (10MG/320MG)

DOSE UNIT: TABLET(S)

NUMERIC DOSE: 1

1 TABLET (10MG/320MG)



User Manual

Drug: CHLORAL HYD. SYR. 500MG/5ML (OZ)


1 TEASPOONFUL


NUMERIC DOSE: 500

1 TEASPOONFUL


If a user presses the <ENTER> key at the ‘DOSE UNIT:’ prompt, they will be prompted to

enter a Numeric Dose. If the user presses the <ENTER> key at the ‘NUMERIC DOSE:’ prompt,

the next available Local Possible Dosage for that drug if one exists with missing data will be

displayed. If no more Local Possible Dosages exist for the drug that require data population, the

next drug and its Local Possible Dosages will be presented for editing.

If the user up-arrows (^) at the ‘DOSE UNIT:’ prompt, they will be asked if they want to

continue. If the response is ‘Yes’, the next Local Possible Dosage with missing data for that drug

will be displayed, if any exist. If no more Local Possible Dosages exist for the drug, the next

drug will display. If the user responds ‘No’, the a check will be made to see if any Local

Possible Dosages still require data to be entered and inform the user.

The user will be informed when all required data has been entered.

Select Enhanced Order Checks Setup Menu Option: Find Unmapped Local Possible Dosages

This option will find all Local Possible Dosages that are eligible for Dosage

Checks that do not have either the Numeric Dosage or Dose Unit entered for the

Local Possible Dosage. This mapping is necessary to perform Dosage checks.

Searching for local Possible Dosages...

Drug: CHLORAMPHENICOL 0.5% OPTH SOL


1 DROP

DOSE UNIT: <ENTER>

NUMERIC DOSE: <ENTER>

2 DROP(S)

DOSE UNIT: <ENTER>

NUMERIC DOSE: <ENTER>

Drug: CLOTRIMAZOLE ORAL TROCHES

Strength: 10 Unit: MG

1 TROCHE

DOSE UNIT: ^

Do you want to continue mapping Local Possible Dosages? Y// <ENTER> ES


User Manual

2 TROCHE(S)

DOSE UNIT: ^

Do you want to continue mapping Local Possible Dosages? Y// NO

Checking for any remaining unmapped Local Possible Dosages...

There are still Local Possible Dosages not yet mapped,

see the 'Local Possible Dosages Report' option for more details.


OR

All Local Possible Dosages are mapped!

1.24.4 Enable/Disable Dosing Order Checks [PSS DOSING ORDER CHECKS]

The Enable/Disable Dosing Order Checks [PSS DOSING ORDER CHECKS] is a stand-alone

option that exists ONLY as a way to turn on/off the database connection for Dosing order

checks. This option should only be used if authorized by Pharmacy Benefits Management

(PBM). PBM will only authorize if local approval has been granted by the Medical Center

Patient Safety Office and the Medical Center Director. PBM should be notified of this decision

by the Pharmacy Chief via email to the VHAPBH PMO Outlook mail group. PBM in turn will

notify Patient Care Services, the National Patient Safety Office and the Office of Information

and Technology (OIT).

When disabled, NO Dosing order checks will be performed in Outpatient Pharmacy, Inpatient

Medication applications, or in the Computerized Patient Record System (CPRS). The option is

locked with the PSS ORDER CHECKS security key.

A notification message will be sent to the Outlook mail group, VHAPBH MOCHA Dosing

Disconnect Notify and the local VistA mail group, PSS ORDER CHECKS when Dosing Order

Checks are disabled or re-enabled using the Enable/Disable Dosing Order Checks option. The

message will provide the following information:

• The name of the person who disabled or re-enabled Dosing Order Checks

• The name of the user’s facility (Outlook message only)

• Date/time the action occurred

• Whether the Dosing Order Checks were disabled or re-enabled

An audit trail will be maintained whenever Dosing Order Checks are disabled or re-enabled in

the Pharmacy System File. The following information will be stored:

• The name of the person who disabled or re-enabled Dosing Order Checks

• The name of the user’s facility (Outlook message only)

• Date/time the action occurred


User Manual

• Whether the Dosing Order Checks were disabled or re-enabled

This option is NOT exported as part of the main Pharmacy Data Management [PSS MGR] menu

option.

Note: The Dosage Checks are exported as turned ON in patch PSS*1*160.

Example 1: Disabling Dosing Order Checks

Select OPTION NAME: PSS DOSING ORDER CHECKS Enable/Disable Dosing Order Checks

Dosing Order Checks are currently ENABLED.

Do you wish to DISABLE Dosing Order Checks? NO// YES

Have you received authorization from Pharmacy Benefits Management (PBM)

to take this action? NO// YES

NO Dosing Order Checks will be performed during order entry in CPRS

or Pharmacy while Dosing Order Checks are disabled!!!

Notification of this action will be sent to PBM and local VistA

PSS ORDER CHECKS mail group.

Are you sure you want to DISABLE Dosing Order Checks? NO// YES

Dosing Order Checks DISABLED.


Example 2: Enabling Dosing Order Checks

Select OPTION NAME: PSS DOSING ORDER CHECKS Enable/Disable Dosing Order Checks


WARNING! Dosing Order Checks are currently DISABLED.

No Dosing Order Checks will be performed during order entry in CPRS or

Pharmacy while Dosing Order Checks are disabled!!!

Do you wish to ENABLE Dosing Order Checks? YES//

Dosing Order Checks ENABLED.


1.24.5 All Stand-Alone Menu Items

The following is a list of all stand-alone options that are NOT exported as part of the main PDM

menu [PSS MGR]:

*Other Language Translation Setup [PSS OTHER LANGUAGE SETUP]

Drug Inquiry (IV) [PSSJI DRUG INQUIRY]



User Manual

[PSSJI ELECTROLYTE FILE]


[PSS ENABLE/DISABLE DB LINK]

Find Unmapped Local Possible Dosages

[PSS LOCAL DOSAGES EDIT ALL]

Add Default Med Route

[PSS ADD DEFAULT MED ROUTE]


[PSS DOSING ORDER CHECKS]

The Enable/Disable Vendor Database Link [PSS ENABLE/DISABLE DB LINK]

option exists ONLY as a way for technical personnel to turn on/off the database

connection if required for debugging. Normally, it is enabled and the Vendor Database

updates are performed centrally on the MOCHA servers, not at the individual sites. This

option is rarely used. It is NOT exported as part of the main PDM menu [PSS MGR]

In the rare case where this option is used and the database link is disabled, NO drug-drug

interaction, duplicate therapy, or dosing order checks will be performed in Pharmacy or

in the Computerized Patient Record System (CPRS).

* Other Language Translation Setup [PSS OTHER LANGUAGE SETUP] is a stand-alone

option that must be assigned to the person(s) responsible for maintaining it.

The Enable/Disable Dosing Order Checks [PSS DOSING ORDER CHECKS] option

should only be used if authorized by PBM.


User Manual

Chapter Two Understanding Dosages

Dosages are compiled by collecting information that was previously entered in various files and

gathering that information to populate individual fields within the DRUG file (#50). Two types

of dosages, Possible Dosages and Local Possible Dosages, are now stored in the DRUG file

(#50). Explanations of what determines a Possible Dosage and a Local Possible Dosage are

included below, along with diagrams to aid the user in understanding which files and fields

contribute to constructing Possible Dosages and Local Possible Dosages. More detailed

information on Possible Dosages and Local Possible Dosages is contained in the Pharmacy

Ordering Enhancements Pharmacy Data Management Pre-Release Implementation Guide,

located on the VistA Documentation Library (VDL) web page at http://vista.med.va.gov/vdl.

2.1 Possible Dosages

The PROPRANOLOL TAB example in Diagram A is an example of a drug that can have

Possible Dosages. Possible Dosages can be broken down into four individual fields; DISPENSE

UNITS PER DOSE, DOSE, PACKAGE, and BCMA DISPENSE UNITS PER DOSE. For a

drug to have Possible Dosages it must meet the following criteria.

1) The drug must be matched to a VA PRODUCT file (#50.68) entry in National

Drug File.

2) The match in National Drug File must be an active single-ingredient product.

3) The strength of the product must be numeric.

4) The Dosage Form/Unit Combination of the product must be marked as

convertible in the DOSAGE FORM file (#50.606). See the table below for a list of

Dosage Form/Unit Combinations that will automatically be identified by the

software.

The Dosage Form/Unit Combinations that have been designated as convertible for the creation of

Possible Dosages are displayed in Appendix A.

Possible Dosages (cont.)

The Possible Dosages option identifies drugs that meet the four criteria mentioned earlier, and by

utilizing fields in the VA PRODUCT file (#50.68) and the DOSAGE FORM file (#50.606), it

will populate the DRUG file (#50) entry with Possible Dosage information.

Diagram A is an example of how the PROPRANOLOL HCL 20MG TAB drug entry

would exist under the current file setup

http://vista.med.va.gov/vdl


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Diagram A


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Diagram A

The VA Product match for this drug is PROPRANOLOL HCL 20MG TAB. It is a single

ingredient product with a numeric Strength (20). It has a Dosage Form of TAB and units of MG

in the VA PRODUCT file (#50.68). Additionally, the non-editable multiple field called UNITS

from the DOSAGE FORM file (#50.606) indicates which combination of Dosage Form and

Units can be converted to Possible Dosages, assuming that the product is a single ingredient drug

with a numeric strength. It also indicates the package (Inpatient Medications, Outpatient

Pharmacy, or both) for which Possible Dosages can be created. So, in the first PROPRANOLOL

example, the Dosage Form/Unit Combination of TAB/MG is convertible for both Inpatient

Medications and Outpatient Pharmacy. The DISPENSE UNITS PER DOSE multiple of the

DOSAGE FORM file (#50.606) is a non-editable field used to calculate dosages during the

dosage creation process. 1, or 1 and 2, were chosen for all Dosage Forms because they require

the least amount of editing in the DRUG file (#50). (See Diagram B.)


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Diagram B


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Diagram B

Diagram B shows the drug entry with the new data. Two new fields, STRENGTH field (#901)

and UNIT field (#902), have been added to the DRUG file (#50). These two fields are populated

with data based on the data contained in the STRENGTH field (#2) and UNITS field (#3) of the

VA PRODUCT file (#50.68) match. The DOSE field (#1) of the POSSIBLE DOSAGE multiple

(#903) of the DRUG file (#50) is populated by multiplying the entry in the DISPENSE UNITS

PER DOSE field (#.01) of the POSSIBLE DOSAGE multiple (#903) of DRUG file (#50) by the

numeric value of the STRENGTH field in the DRUG file (#50). (DOSE=DISPENSE UNITS

PER DOSE x STRENGTH)

Diagram C shows dosage selections for a PROPRANOLOL TAB Orderable Item when one or

more drugs are matched to that Orderable Item. (See Diagram C.)


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Diagram C

Diagram C

In Diagram C, the PROPRANOLOL drug entries are matched to VA Products that have numeric

strengths, 20 and 40, and the VA Products both have the Dosage Form/Unit Combination of

TAB/MG. Since TAB/MG is marked as “convertible” in the DOSAGE FORM file (#50.606) for

both Inpatient Medication and Outpatient Pharmacy, the new STRENGTH field (#901) and

UNIT field (#902) in the DRUG file (#50) for these drugs can be populated by the software. The

STRENGTH field (#901) and UNITS field (#902) of DRUG file (#50) are populated from the

VA PRODUCT file (#50.68) into the DRUG file (#50).

The new fields in the POSSIBLE DOSAGES multiple (#903) of the DRUG file (#50),

DISPENSE UNITS PER DOSE field (#.01), DOSE field (#1), and PACKAGE filed (#2), are

now populated with data. The Dispense Units Per Dose of “1” and “2” came from the new

DISPENSE UNITS PER DOSE multiple (#9) in the DOSAGE FORM file (#50.606). When this

data is carried over to the DRUG file (#50), the dose is computed by multiplying the Dispense

Units Per Dose from DRUG file (#50) by the Strength from DRUG file (#50) of each drug. The

PACKAGE field values of the DOSAGE FORM file (#50.606), “I” for Inpatient Medications

and “O” for Outpatient Pharmacy, are also copied to the PACKAGE field of DRUG file (#50).

Some of the Possible Dosages will be converted for both packages, such as the combination of


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TAB/MG, since this type of dosage can be ordered for Inpatient Medications and also can be

converted to a patient readable Outpatient Pharmacy SIG. Other Dosage Form/Unit

Combinations, such as SYRUP/MG/5ML, can only be converted for Inpatient Medications since

they cannot be easily changed to an Outpatient Pharmacy readable SIG.

In this example, PROPRANOLOL TAB is selected as the Orderable Item in CPRS, therefore the

dose selection would be:

20MG

40MG

80MG

Notice that there is only one 40MG selection for the provider, yet both the PROPRANOLOL

HCL 20MG TAB drug and the PROPRANOLOL HCL 40MG TAB drug entries have doses of

40MG. In this case, the 40MG dose is associated with the PROPRANOLOL HCL 40MG TAB

drug, because it has a lower Dispense Units Per Dose (1), than the Dispense Units Per Dose (2)

associated with the 40MG dose for the PROPRANOLOL HCL 20MG TAB.

For Possible Dosages, when the software encounters two doses that are the same,

the lowest Dispense Units Per Dose will be used to determine the Dispense Drug.

Additionally, another screen that is used for duplicate doses is the non-formulary screen.

If there are two of the same doses, and one is formulary and the other is non-

formulary, the formulary entry is the one that is used, regardless of which dose has

the lower Dispense Units Per Dose value.

The non-formulary drug filter is executed prior to the lowest Dispense Units Per Dose filter. So

in this example, if the PROPRANOLOL HCL 40MG TAB is marked as non-formulary, and the

PROPRANOLOL HCL 20MG TAB is formulary, the 40MG dosage selection would be

associated with the PROPRANOLOL HCL 20MG TAB, even though it has a higher Dispense

Units Per Dose (2) than the 40MG entry for PROPRANOLOL HCL 40MG TAB (1 Dispense

Units Per Dose).

Once the Possible Dosages have been created, doses can be deleted or added by editing the

DISPENSE UNITS PER DOSE field (#.01) of the POSSIBLE DOSAGE multiple (#903) of the

DRUG (#50) File using the Enter/Edit Dosages [PSS EDIT DOSAGES] option. The DOSE field

(1) of the POSSIBLE DOSAGE multiple (#903) of the DRUG (#50) File is automatically

calculated by multiplying the DISPENSE UNITS PER DOSE field (#.01) of the POSSIBLE

DOSAGE multiple (#903) of the DRUG (#50) File times the STRENGTH field (#901). For

example, if the PROPRANOLOL TABLET is commonly given in a 10MG dose, and there is not

a Dispense Drug entry in DRUG file (#50) of PROPRANOLOL HCL 10MG TAB, a Dispense

Units Per Dose of .5 can be added for the PROPRANOLOL HCL 20MG TAB, and a dose of

10MG will be created. If a dose of 60MG is sometimes given for PROPRANOLOL TAB,


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entering a Dispense Units Per Dose of 3 for the PROPRANOLOL HCL 20MG TAB drug will

provide a 60MG dose. Similarly, if the 80MG dose is rarely given, the Dispense Units Per Dose

of 2 can be deleted for the PROPRANOLOL HCL 40MG TAB drug, and the 80MG dose will be

deleted.

The PACKAGE field (#2) of the POSSIBLE DOSAGE multiple (#903) of the DRUG file (#50)

can also be edited, but this is a “controlled” type of edit. If the Dosage Form/Unit Combination is

not marked as convertible in the DOSAGE FORM file (#50.606) for the package, then that

package cannot be added as a package for that Possible Dosage. Strength can also be edited in

the DRUG file (#50). If the strength is edited, then all of the doses are automatically re-

calculated based on the DISPENSE UNITS PER DOSE and new STRENGTH entry. It is

recommended that the strength only be edited in the rare case that the Dispense Drug must be

matched to a VA Product with an inappropriate strength. (This scenario is discussed in further

detail later in this document.) In summary, by adding new DISPENSE UNITS PER DOSE of .5

and 3 to the PROPRANOLOL HCL 20MG TAB entry, and by deleting the DISPENSE UNITS

PER DOSE of 2 for the PROPRANOLOL HCL 40MG TAB entry, the following Possible

Dosages now exist for PROPRANOLOL TAB Orderable Item. (See Diagram D.)


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Diagram D

Diagram D

Though the list of dosages is all that the provider will see for selection, each of the dosages is

associated with a Dispense Drug. For example, if the 60MG is selected, the Dispense Units Per

Dose is 3, and the drug is PROPRANOLOL HCL 20MG TAB. For Outpatient Pharmacy orders

the SIG will be built in the same manner as it is today. If the 60MG is chosen, the SIG will begin

with “TAKE 3 TABLETS…” and the assigned Dispense Drug is PROPRANOLOL HCL 20MG

TAB.

As demonstrated in the PROPRANOLOL example, the key to populating the Possible Dosages

in the DRUG file (#50) is the information that is contained in the VA PRODUCT file (#50.68)

entry to which that drug is matched. Earlier diagrams also show that dosages can be added,

deleted, etc., for a drug by editing the DISPENSE UNITS PER DOSE field (#.01) of the

POSSIBLE DOSAGE multiple (#903) of the DRUG file (#50) for that drug.

In addition to creating Possible Dosages for a drug by editing the DISPENSE UNITS PER

DOSE field (#.01) of the POSSIBLE DOSAGE multiple (#903) of the DRUG file (#50),


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appropriate Possible Dosages can be created by editing the STRENGTH field (#901) for a drug.

When Possible Dosages are created for a drug, the strength information from the VA Product

match is moved to the drug entry and stored in the STRENGTH field (#901). The only time this

data would not be accurate would be if a VA PRODUCT file (#50.68) entry with the correct

strength did not exist, and a different strength of the drug had to be selected for the drug’s VA

Product match; however, these instances should be rare. If the desired strength does not exist for

a particular drug, the functionality exists to edit the STRENGTH field (#901) in the DRUG file

(#50) for that drug. Once the strength edit is completed, new Possible Dosages are created for

every Dispense Units Per Dose for that drug.

For example, Diagram E shows an entry in the DRUG file (#50) of METOPROLOL

TARTRATE 25MG TAB. No entries with a strength of 25 exist in the VA PRODUCT file

(#50.68) for that drug, so it is matched instead to a VA Product entry with a strength of 50. (See

Diagram E.)


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Diagram E

Diagrams E and F

In Diagram E, the Possible Dosages created are 50 MG (1 tablet) and 100MG (2 tablets), but the

drug is actually METOPROLOL TARTRATE 25MG TAB. These Possible Dosages were

created because the strength of the VA PRODUCT file (#50.68) entry is 50. As displayed in

Diagram F, the strength in the DRUG file (#50) can simply be edited from 50 to 25, and when

that strength is edited, the Possible Dosages for all Dispense Units Per Dose, in this case 1 and 2,

will be recalculated. (See Diagram F.)


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Diagram F

2.2 Local Possible Dosages

Diagram G

In an earlier example using PROPRANOLOL TAB, Inpatient Medications and Outpatient

Pharmacy Possible Dosages could be created for the Dispense Drugs matched to

PROPRANOLOL TAB because they met all of the following four criteria.


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1) The drug must be matched to a VA PRODUCT file (#50.68) entry in National Drug

File.

2) The match in National Drug File must be an active single-ingredient product.

3) The strength of the product must be numeric.

4) The Dosage Form/Unit Combination of the product must be marked as convertible

in the DOSAGE FORM file (#50.606).

In the following example, the Orderable Item requested is TIMOLOL SOLN, OPH, which has

two Dispense Drugs matched to it. Neither of these Dispense Drugs meets the four criteria for

creating Possible Dosages. The two Dispense Drugs are matched to entries in the VA

PRODUCT file (#50.68) as follows. (See Diagram G.)


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Diagram G

Diagram G (continued)

These two drugs meet the first three of the Possible Dosages criteria, but do not meet criteria

number four. The Dosage Form/Unit Combination of SOLN,OPH / % is not marked as

convertible in the DOSAGE FORM file (#50.606) for Inpatient Medications or for Outpatient

Pharmacy. Since Possible Dosages cannot be created for these drugs, Local Possible Dosages

must be created. To create Local Possible Dosages the Noun field in the DOSAGE FORM file

(#50.606) is utilized. By default, all Local Possible Dosages will be marked for Inpatient

Medications and/or Outpatient Pharmacy use based on the package identification of the Noun.

The NOUN field (#.01) of the NOUN multiple (#6) of the DOSAGE FORM file (#50.606)

already exists in the DOSAGE FORM file (#50.606). It is a multiple field, meaning that more


User Manual

than one Noun can be associated with each Dosage Form. Some Dosage Forms may have

multiple Nouns, while other Dosage Forms may have only one Noun. For example, the Dosage

Form CREAM could have the following entries in the NOUN field.

LIBERALLY

SMALL AMOUNT

SPARINGLY

THIN FILM

Alternately, the Dosage Form of TAB would most likely only have one NOUN, TABLET(S).

TABLET(S)

In the TIMOLOL example, a review of the Dosage Form entry for SOLN,OPH, shows that the

Dispense Units Per Dose of 1 and 2 are designated, and a Noun of DROP(S) is specified. If the

Auto Create Dosages option is rerun with the current setup, no Possible Dosages for the two

TIMOLOL drugs will be created because the drugs do not meet all four Possible Dosages

criteria. Local Possible Dosages will be created of 1 DROP and 2 DROPS.

If a NOUN ends in “(S)” or “(s)”, such as TABLET(S) or capsule(s), the “(S)” or “(s)” will be

completely dropped from the Noun when building the SIGs, as long as the Dispense Units Per

Dose is 1 or less. If the Dispense Units Per Dose is greater than 1, the parenthesis around the

“(S)” will be eliminated, creating a plural Noun, such as TABLETS. For this to happen, the

Noun must precisely end in the three characters “(S)”.

Keep in mind that if an Orderable Item is selected in CPRS, and there are Possible Dosages for

any of the Dispense Drugs tied to that Orderable Item, only the Possible Dosages will be

returned and any Local Possible Dosages will be ignored. Local Possible Dosages will only be

used when no Possible Dosages can be found for drugs tied to the selected Orderable Item and

identified for use by the selected application (Inpatient Medications or Outpatient Pharmacy).

In the TIMOLOL example, the Noun of DROP(S) and the Dosage Form of SOLN, OPH

produces the following results. (See Diagram H.)


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Diagram H

2.3 Possible Dosages and Local Possible Dosages

The following dosage example is of a Dispense Drug that has Possible Dosages for Inpatient

Medications and Local Possible Dosages for Outpatient Pharmacy. The Dispense Drug is

PROMETHAZINE HCL 25MG/5ML SYRUP.

The reason Possible Dosages were created only for Inpatient Medications is because the units of

25 MG/5ML for the SYRUP Dosage Form was only marked convertible for Inpatient

Medications.

Local Possible Dosages will only be used to display in the dosage list when no Possible

Dosages can be found for drugs tied to the selected Orderable Item and identified for use

by the selected application (Inpatient Medications or Outpatient Pharmacy).


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Diagram I


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Diagram I

Diagram I illustrates the Possible Dosages and Local Possible Dosages that would be created for

PROMETHAZINE HCL 25MG/5ML SYRUP. On the following page, Diagram J illustrates an

edit of the STRENGTH field (#901) in DRUG file (#50) for a product such as

PROMETHAZINE which has volume related UNITS. In the background, the software will

evaluate the UNIT field in the DRUG file (#50) to determine if an adjustment in the UNIT is

necessary. The software will search for the existence of a “/” in the UNIT field. If the UNIT field

contains a “/”, when the strength is edited, calculations will be performed to make appropriate

adjustments in the value of the UNIT. For example, the DRUG file (#50) entry may have a

STRENGTH of 25 and a UNIT of MG/5ML. If the STRENGTH is edited to 12.5, the UNIT will

be adjusted by the software to MG/2.5ML.

When the UNIT value is adjusted, it will not display in the DRUG file (#50); however,

throughout all Pharmacy and CPRS displays, the correct, adjusted unit value of the dosage will

be displayed. (See Diagram J.)


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Diagram J

2.4 Multi-Ingredient Drugs

The following are examples of multi-ingredient drugs. Since multi-ingredient drugs do not meet

the criteria for creation of a Possible Dosage, Local Possible Dosages will be created based on

the Noun entries in the DOSAGE FORM file (#50.606).

The first example is GUAIFENESIN SYRUP WITH CODEINE 4oz. The Dosage Form of

SYRUP has three Nouns, all marked for Inpatient Medications and Outpatient Pharmacy use.

These Nouns are TABLESPOONFUL(S), TEASPOONFUL(S), and ML(S). The

APPLICATION PACKAGE USE field of the Dispense Drug is marked for Outpatient Pharmacy

use only. (See Diagram K.)


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Diagram K


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Chapter Three Creating the Sig

3.1 Creating the Sig

Earlier versions of the Outpatient Pharmacy software allowed the SIG to be directly edited from

within the Outpatient Pharmacy package. Following the release of the Pharmacy Ordering

Enhancements (POE) Phase 2 project, however, which included patches PSO*7*46, OR*3*94,

PSS*1*38, and PSJ*5*50, the SIG could no longer be edited as a unit. Now, instead, individual

fields are populated and then concatenated to create the SIG. Although the SIG, as a unit, cannot

be edited, each individual field that creates the SIG can be edited until the SIG displays as

desired.

Four basic types of SIGs exist: Simple Possible Dosages, Simple Local Possible Dosages,

Complex Possible Dosages, and Complex Local Possible Dosages. The SIG for each of these

types of dosages is created by combining fields from various PDM files. To simplify the process,

each dosage can be thought of as having its own SIG “formula”. The key to the formulas is

displayed in the following table. The formulas for creating each of the four types of SIGs follow.

The following table details the symbols that will be used in the SIG tables.

Table A: Formula Symbols

Symbol File Symbol File

Verb

DOSAGE FORM file

(#50.606)

Outpatient

Expansion

MEDICATION ROUTES

file (#51.2)

Dispense

Units/Dose

DRUG file (#50) Schedule

Expansion

ADMINISTRATION

SCHEDULE file (#51.1) or

MEDICATION

INSTRUCTION file (#51)

Local

Possible

Dosage

DRUG file (#50)

Patient

Instructions

+/or

Provider

Comments

PHARMACY

ORDERABLE ITEM file

(#50.7) or Provider

Comments entered with

CPRS orders

Noun

DOSAGE FORM file

(#50.606) Conjunction

AND, THEN or EXCEPT

Preposition

DOSAGE FORM file

(#50.606) Duration

HOURS, MINUTES,

DAYS

August 2018 Pharmacy Data Management V. 1.0 201

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3.2 SIG Formulas (Visual)

Simple Possible Dosages

+ + + + +Noun+

Patient

Instructions

+/or

Provider

CommentsDispense

Units/Dose

PrepositionVerbOutpatient

Expansion from

MEDICATION

ROUTE file (#51.2)

Schedule

Expansion

Simple Local Possible Dosages

+ + + ++ PrepositionVerbSchedule

ExpansionLocal

Possible

Dosage

Patient

Instructions

+/or

Provider

Comments

Outpatient Expansion

from MEDICATION

ROUTE file (#51.2)

Complex Possible Dosages

Dispense

Units/Dose

Noun

Patient

Instruction

+/or

Provider

Comments

PrepositionVerb

Outpatient

Expansion

from MEDICATION

ROUTE file (#51.2)

Schedule

Expansion+ + + + + Duration + (Repeat as

Needed) +Conjunction+

Complex Local Possible Dosages

Patient

Instruction

+/or Provider

Comments

PrepositionVerb

Outpatient

Expansion

from MEDICATION

ROUTE file (#51.2)

Local

Possible

Dosage

Schedule

Expansion+ + + + + Duration + (Repeat as

Needed) +Conjunction


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3.3 SIG Formulas

Each of the four types of dosages, Simple Possible Dosages, Complex Possible Dosages, Simple

Local Possible Dosages, and Complex Local Possible Dosages, can be created using the dosage’s

respective SIG formula. The formulas, along with examples of various SIGs, are explained in

detail below.

Simple Possible Dosages

Dosages that have a numeric dosage and numeric Dispense Units Per Dose appropriate for

administration are called Possible Dosages. For a drug to have Possible Dosages, it must be a

single-ingredient product that is matched to a VA PRODUCT file (#50.68) entry in the National

Drug File. The National Drug File entry must have a single numeric strength and the Dosage

Form/Unit Combination must be such that a numeric strength combined with the unit can be an

administrable dosage selection. The formula for creating a SIG for a Simple Possible Dosage is

displayed below. The charts following the formula define how various sample SIGs were created

using this formula.

Simple Possible Dosage Formula

+ + + + +Noun+

Patient

Instructions

+/or

Provider

CommentsDispense

Units/Dose

PrepositionVerb

Outpatient

Expansion form

MEDICATION

ROUTES file

(#51.2)

Schedule

Expansion

A SIG for a Simple Possible Dosage can be created utilizing the above formula. Prior to creating

a SIG, the SIG must first be broken down into each of the elements in its respective Dosage

Formula. The table below outlines each element of the desired SIG. By identifying the element

symbol to the right of the SIG entry, it is easy to identify which element that word or phrase

represents. For example, to the right of the SIG entry, “TAKE”, in the table, the Verb symbol is

displayed. By referencing the third column, it is apparent that Verb entries are taken from the

DOSAGE FORM file (#50.606).

The following tables define each element of the SIG for each of the four types of dosages,

Simple Possible Dosages, Complex Possible Dosages, Simple Local Possible Dosages, and

Complex Local Possible Dosages and identify which files provide each element’s information.

The complete SIG is displayed at the top of each table.

Each part of the SIG is constructed by extracting data from a designated file within the Pharmacy

software. The verb entry is derived from the DOSAGE FORM file (#50.606) entry of the Dosage

Form that is associated with the Pharmacy Orderable Item. The Dispense Units Per Dose of 2 is a

component of the Possible Dosage and is also provided by the software.


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Example: Simple Possible Dosage

TAKE TWO TABLETS BY MOUTH EVERY 12 HOURS

AFTER MEALS

ENTRY ELEMENT FILE

TAKE Verb

DOSAGE FORM file (#50.606)

2 Dispense

Units/Dose DRUG file (#50)

TABLETS Noun


BY Preposition


MOUTH Outpatient

Expansion

from MEDICATION

ROUTE file (#51.2)

MEDICATION ROUTES file

(#51.2)

EVERY 12

HOURS Schedule

Expansion

ADMINISTRATION SCHEDULE file

(#51.1) or MEDICATION INSTRUCTION file (#51)

AFTER MEALS

Patient

Instruction

+/or

Provider

Comments

PHARMACY ORDERABLE ITEM file (#50.7)

or

CPRS

Required elements for every Possible Dosage are the Dosage (Dispense Units Per Dose and

Noun) and the schedule. Any other element may be deleted from the SIG. If a SIG contains a

medication route, and that medication route is changed or deleted, a new order will be created

due to the change to the MEDICATION ROUTES file (#51.2). A change to the dosage and/or

schedule will also create a new order.

Example: Simple Possible Dosage

TAKE TWO TABLETS EVERY 12 HOURS

ENTRY ELEMENT FILE

TAKE Verb


TWO Dispense

Units/Dose DRUG file (#50)

TABLETS Noun


EVERY 12

HOURS Schedule

Expansion

ADMINISTRATION SCHEDULE file (#51.1) or MEDICATION INSTRUCTION file (#51)


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The SIG of an order for a medication with Local Possible Dosages may contain the same

elements as a Possible Dosage, except that the Local Possible Dosage replaces the Dispense

Units Per Dose and Noun elements.

Example: Local Possible Dosage

APPLY THIN FILM TO AFFECTED AREA TWICE DAILY AFTER

WASHING THOROUGHLY

ENTRY ELEMENT FILE

APPLY Verb


THIN FILM Local

Possible

Dosage

DRUG FILE (#50)

TO Preposition


AFFECTED AREA

Outpatient

Expansion

from M EDICATION

ROUTE file (#51.2)

MEDICATION ROUTES file

(#51.2)

TWICE DAILY Schedule

Expansion

ADMINISTRATION


MEDICATION

INSTRUCTIONS file (#51)

AFTER WASHING

THOROUGHLY

P atien t

Instruction s

+/or

Provider

Com m ents

ORDERABLE ITEM file (#50.7)

or

CPRS

CPRS entered provider comments may be copied into the PATIENT INSTRUCTIONS field.

These Patient Instructions will then print at the end of the SIG. If Patient Instructions exist at the

Pharmacy Orderable Item level, the CPRS provider will view them when the order is being

entered and can select whether or not to include them as part of the order. If the provider elects to

not include the Pharmacy Orderable Item Patient Instructions as a part of the order, they will not

appear in the PATIENT INSTRUCTIONS field of the pending order.

The following Complex Local Possible Dosage would apply to a multi-ingredient liquid product,

such as Mylanta or Maalox. In this case, 1 TABLESPOONFUL was entered as a Local Possible

Dosage in DRUG file (#50).


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------------------------Table demonstrating Complex Local Possible Dosage Follows-----------------

Example: Complex Local Possible Dosage

TAKE 1 TABLESPOONFUL BY MOUTH EVERY

FOUR HOURS FOR 3 DAYS THEN TAKE 1

TABLESPOONFUL AS NEEDED

ENTRY ELEMENT FILE

TAKE Verb

DOSAGE FORM

file (#50.606)

1

TABLESPOONFUL Local

Possible

Dosage

DRUG FILE (#50)

BY Preposition

DOSAGE FORM

file (#50.606)

MOUTH

Outpatient

Expansion

from MEDICATION

ROUTE file (#51.2)

MEDICATION

ROUTES file (#51.2)

EVERY FOUR

HOURS Schedule

Expansion

ADMINISTRATION

SCHEDULE file

(#51.1) or

MEDICATION

INSTRUCTION file

(#51)

FOR 3 DAYS Duration

IN DAYS, HOURS,

MINUTES

THEN Conjunction

AND, THEN, or

EXCEPT

TAKE Verb

DOSAGE FORM

file (#50.606)

1

TABLESPOONFUL Local

Possible

Dosage

DRUG FILE (#50)

AS NEEDED Schedule

Expansion

ADMINISTRATION

SCHEDULE file

(#51.1) or

MEDICATION

INSTRUCTION file

(#51)


User Manual

The following complex order for a medication with Local Possible Dosages illustrates the

elements utilized to build an order for a medication to be given for a specified duration before

changing the frequency of administration. The CONJUNCTION field is used to join dosing

sequences for a complex order. The entries are limited to “AND,” “THEN,” or “EXCEPT.”

“AND” is used for concurrent doses in a complex order, such as “Take 1 tablet every morning

AND take 2 tablets at bedtime.” “THEN” is used for consecutive doses in a complex order, for

example “Take 2 tablets daily for one week THEN take 1 tablet daily for five days.” “EXCEPT”

can be used in a complex order to describe any dosing order that is not routine, as in “Take 1

tablet every day EXCEPT take no tablets Wednesday.”

Example 1: Complex Local Possible Dosage

APPLY THIN FILM TO AFFECTED AREAS FOUR TIMES

DAILY FOR 1 WEEK THEN APPLY DAILY AS NEEDED

ENTRY ELEMENT FILE

APPLY Verb

DOSAGE FORM file

(#50.606)

THIN FILM Local

Possible

Dosage

DRUG FILE (#50)

TO Preposition

DOSAGE FORM file

(#50.606)

AFFECTED AREAS

Outpatient

Expansion

from MEDICATION

ROUTE file (#51.2)

MEDICATION ROUTES

file (#51.2)

FOUR TIMES DAILY Schedule

Expansion

ADMINISTRATION


MEDICATION


FOR 1 WEEK Duration

IN DAYS, HOURS,

MINUTES

THEN Conjunction

AND, THEN or EXCEPT

APPLY Verb

DOSAGE FORM file

(#50.606)

DAILY AS NEEDED Schedule

Expansion

ADMINISTRATION


MEDICATION



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(This page left blank for two-sided copying)


User Manual

Glossary

Administration Schedule File The ADMINISTRATION SCHEDULE file (#51.1) contains

administration schedule names and standard dosage

administration times. The name is a common abbreviation

for an administration schedule (e.g., QID, Q4H, PRN). The

administration time is entered in military time.

CPRS A VistA computer software package called Computerized

Patient Record System. CPRS is an application in VistA that

allows the user to enter all necessary orders for a patient in

different packages from a single application.

DATUP Functionality that allows the Pharmacy Enterprise

Customization System (PECS) to send out custom and

standard commercial-off-the-shelf (COTS) vendor database

changes to update the two centralized databases at Austin

and Martinsburg.

Dispense Drug The Dispense Drug is pulled from DRUG file (#50) and

usually has the strength attached to it (e.g., Acetaminophen

325 mg). Usually, the name alone without a strength

attached is the Pharmacy Orderable Item name.

Dosage Form File The DOSAGE FORM file (#50.606) contains all dosage

forms and associated data that are used by Pharmacy

packages and CPRS. The dosage form is used in SIG

construction, default values and in the determination of the

type of each dosage created for each application.

Dose Units File

Dose Unit Conversion File

The DOSE UNITS file (#51.24) was created to accomplish

the mapping to First Databank (FDB). All entries in this file

have been mapped to an FDB Dose Unit. Although this file

has not yet been standardized by Standards and

Terminology Services (SRS), no local editing will be

allowed. When populating the Dose Unit field for a Local

Possible Dosage, selection will be from this new file.

The DOSE UNIT CONVERSION file (#51.25) was created to

convert one dose unit to another using a conversion factor so that

a comparison can be made between two dose units when they are

not equivalent. The dose unit used for the Dosing Order Check

may not be the same dose unit First Databank (FDB) returns with

the Dosing Order Check results.


User Manual

Drug Electrolytes File The DRUG ELECTROLYTES file (#50.4) contains the

names of anions and their cations and concentration units.

Drug File The DRUG file (#50) holds the information related to each

drug that can be used to fill a prescription or medication

order. It is pointed to from several other files and should be

handled carefully, usually only by special individuals in the

Pharmacy Service. Entries are not typically deleted, but

rather made inactive by entering an inactive date.

Drug Text File The DRUG TEXT file (#51.7) stores national and/or drug

restrictions, guidelines, and protocols to help assure

medications are being used according to defined

specifications.

Enhanced Order Checks Drug – Drug Interaction, Duplicate Therapy, and Dosing

order checks that are executed utilizing FDB’s

MedKnowledge Framework APIs and database.

Infusion Instructions File The INFUSION INSTRUCTIONS file (#53.47) holds

abbreviations used when entering the Infusion Rate (#.08) field in

the IV (#100) multiple of the PHARMACY PATIENT (#55)

FILE, AND THE infusion rate (#59) FIELD IN THE non-verified

orders (#53.1) file. Each record holds an expansion of the abbreviation which replaces the abbreviation in the Infusion Rate

at the time the IV order is created.

IV Additives File The IV ADDITIVES file (#52.6) contains drugs that are

used as additives in the IV room. Data entered includes drug

generic name, print name, drug information, synonym(s),

dispensing units, cost per unit, days for IV order, usual IV

schedule, administration times, electrolytes, and quick code

information.

IV Solutions File The IV SOLUTIONS file (#52.7) contains drugs that are

used as primary solutions in the IV room. The solution must

already exist in the DRUG file (#50) to be selected. Data in

this file includes: drug generic name, print name, status,

drug information, synonym(s), volume, and electrolytes.

Local Possible Dosages Local Possible Dosages are free text dosages that are

associated with drugs that do not meet all of the criteria for

Possible Dosages.

Medication Instruction File The MEDICATION INSTRUCTION file (#51) is used by

Unit Dose and Outpatient Pharmacy. It contains the

medication instruction name, Outpatient Pharmacy

expansion, and intended use, as well as other fields.


User Manual

Medication Routes File The MEDICATION ROUTES file (#51.2) contains

medication route names. The user can enter an abbreviation

for each route to be used at their site. The abbreviation will

most likely be the Latin abbreviation for the term.

Medication

Routes/Abbreviations

The MEDICATION ROUTES file (#51.2) contains the

medication routes and abbreviations, which are selected by

each Department of Veterans Affairs Medical Centers

(VAMC). The abbreviation cannot be longer than five

characters to fit on labels and the Medical Administration

Record (MAR). The user can add new routes and

abbreviations as appropriate.

MOCHA Medication Order Check Healthcare Application.

National Drug File The National Drug File provides standardization of the local

drug files in all VA medical facilities. Standardization

includes the adoption of new drug nomenclature and drug

classification and links the local drug file entries to data in

the National Drug File. For drugs approved by the Food and

Drug Administration (FDA), VA medical facilities have

access to information concerning dosage form, strength and

unit; package size and type; manufacturer’s trade name; and

National Drug Code (NDC). The NDF software lays the

foundation for sharing prescription information among

medical facilities.

Non-Formulary Drugs Drugs that are not available for use by all providers.

Order Check Order checks (drug-allergy/ADR interactions, drug-drug,

duplicate drug, duplicate therapy, and dosing) are performed

when a new medication order is placed through either the

CPRS or Inpatient Medications applications. They are also

performed when medication orders are renewed, when

Orderable Items are edited, or during the finishing process

in Inpatient Medications. This functionality will ensure the

user is alerted to possible adverse drug reactions and will

reduce the possibility of a medication error.

Orderable Item An Orderable Item is pulled from the PHARMACY

ORDERABLE ITEM file (#50.7) and usually has no

strength attached to it (e.g., Acetaminophen). The name,

with a strength attached, is the Dispense Drug name (e.g.,

Acetaminophen 325mg).

Orderable Item File The ORDERABLE ITEM file (#101.43) is a CPRS file that

provides the Orderable Items for selection within all


User Manual

Pharmacy packages. Pharmacy Orderable Items are a subset

of this file.

PECS Pharmacy Enterprise Customization System. A Graphical

User Interface (GUI) web-based application used to

research, update via DATUP, maintain, and report VA

customizations of the commercial-off-the-shelf (COTS)

vendor database used to perform Pharmacy order checks

such as drug-drug interactions, duplicate therapy, and

dosing.

Pending Order A pending order is one that has been entered by a provider

through CPRS without Pharmacy finishing the order. Once

Pharmacy has finished (and verified for Unit Dose only) the

order, it will become active.

PEPS Pharmacy Enterprise Product Services. A suite of services

that includes Outpatient and Inpatient services.

Pharmacy Orderable Item

File

The PHARMACY ORDERABLE ITEM file (#50.7)

contains the Order Entry name for items that can be ordered

in the Inpatient Medications and Outpatient Pharmacy

packages.

Possible Dosages Dosages that have a numeric dosage and numeric Dispense

Units Per Dose appropriate for administration. For a drug to

have possible dosages, it must be a single ingredient product

that is matched to National Drug File. The National Drug

File entry must have a numeric strength and the dosage

form/unit combination must be such that a numeric strength

combined with the unit can be an appropriate dosage

selection.

Prompt A point at which the system questions the user and waits for

a response.

Standard Medication Route

File

The STANDARD MEDICATION ROUTES file (#51.23)

was created to map Local Medication Routes in VistA to an

FDB Route in order to perform dosage checks in PRE V.0.5.

This file has been standardized by Standards and

Terminology Service (STS) and is mapped to an FDB

Route. It cannot be edited locally.

Standard Schedule Standard medication administration schedules are stored in

the ADMINISTRATION SCHEDULE file (#51.1) and are

commonly referred to as "Standard Schedules."


User Manual

Units Per Dose The Units Per Dose is the number of Units (tablets,

capsules, etc.) to be dispensed as a dose for an order.

Fractional numbers will be accepted for certain dosage

forms (i.e. tablets, oral solutions, etc.).

VA Drug Class Code A drug classification system used by VA that separates

drugs into different categories based upon their

characteristics. Some cost reports can be run for VA Drug

Class Codes.

VA Product File The VA PRODUCT file (#50.68).


User Manual

Appendix A Convertible Dosage Form/Unit Combinations

Dosage Form Unit Package

CAP,EC MG Both

CAP,INHL MCG Both

MG Both

CAP,ORAL GM Both

MCG Both

MG Both

MG/PKG Both

MIC Both

MIL Both

MIN Both

ML Both

UNT Both

CAP,SA MEQ Both

MG Both

UNT Both

CAP,SPRINKLE MG Both

CAP,SPRINKLE,SA MG Both

DENTAL CONE MG Both

DROPS,ORAL MG/0.6ML Inpatient

MG/ML Inpatient

UNT/ML Inpatient

ELIXIR MEQ/15ML Inpatient

MEQ/5ML Inpatient

MG/10.15ML Inpatient

MG/15ML Inpatient

MG/5ML Inpatient

MG/ML Inpatient

EMULSION GM/15ML Inpatient

UNT Inpatient

ENEMA MG/60ML Inpatient

ENEMA,RTL MG/5ML Inpatient

FLUID EXTRACT GM/ML Inpatient

GEL MCG/0.1ML Inpatient

MG/2.5ML Inpatient

MG/3GM Inpatient

MG/5ML Inpatient

MG/UNT Inpatient

GRANULES GM Inpatient

GM/PKT Inpatient

MG Inpatient


User Manual

MG/5ML Inpatient

GRNL,EFFERVSC MEQ/PKG Inpatient

GRNL,RCNST-ORAL GM/PKG Inpatient

MG/2.5ML Inpatient

MG/5ML Inpatient

MG/ML Inpatient

MG/PKT Inpatient

GUM,CHEWABLE MG Inpatient

IMPLANT MG Inpatient

INJ GM Inpatient

GM/100ML Inpatient

GM/3ML Inpatient

GM/50ML Inpatient

GM/BAG Inpatient

GM/BTL Inpatient

GM/ML Inpatient

GM/VIAL Inpatient

MBq/ML Inpatient

MBq/VIL Inpatient

MCG/0.5ML Inpatient

MCG/ML Inpatient

MCG/VIL Inpatient

MEQ/L Inpatient

MEQ/ML Inpatient

MG Inpatient

MG/0.2ML Inpatient

MG/0.3ML Inpatient

MG/0.4ML Inpatient

MG/0.5ML Inpatient

MG/0.5ML Inpatient


MG/0.6ML Inpatient

MG/0.8ML Inpatient

MG/10ML Inpatient

MG/2ML Inpatient

MG/5ML Inpatient

MG/AMP Inpatient

MG/BAG Inpatient

MG/ML Inpatient

MG/VIAL Inpatient

MIC/VIL Inpatient

MIL/ML Inpatient

MIL/VIL Inpatient

MILLION UNT/VIL Inpatient

ML Inpatient

PNU Inpatient


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PNU/ML Inpatient

UNT Inpatient

UNT/0.1ML Inpatient

UNT/0.2ML Inpatient

UNT/0.5ML Inpatient

UNT/AMP Inpatient

UNT/ML Inpatient

UNT/TEST Inpatient

UNT/VIL Inpatient

mgI/ml Inpatient

nKatU/ML Inpatient

INJ (IN OIL) MG/ML Inpatient

INJ,CONC MG/50ML Inpatient

MG/5ML Inpatient

MG/VIAL Inpatient

MG/ML Inpatient

INJ,CONC, W/BUF MG/ML Inpatient

MG/VIAL Inpatient

INJ,CONC-SOLN MEQ/ML Inpatient

MG/10ML Inpatient

MG/ML Inpatient

INJ,FROZEN MG/ML Inpatient

INJ,LYPHL GM/VIAL Inpatient

MCG/VIL Inpatient

MG/AMP Inpatient

MG/VIAL Inpatient

UNT/AMP Inpatient

UNT/VIL Inpatient

INJ,PWDR GM/BTL Inpatient

GM/VIAL Inpatient

MG Inpatient

MG/VIAL Inpatient

UNT/VIL Inpatient

INJ,REPOSITORY MG/ML Inpatient

UNT/ML Inpatient

INJ,SOLN GM Inpatient

GM/100ML Inpatient

GM/20ML Inpatient

GM/50ML Inpatient

GM/AMP Inpatient

GM/BAG Inpatient

GM/BTL Inpatient

GM/KIT Inpatient

GM/ML Inpatient

GM/VIAL Inpatient

MCG/0.3ML Inpatient


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MCG/0.5ML Inpatient

MCG/ML Inpatient

MEQ/100ML Inpatient

MEQ/50ML Inpatient

MEQ/ML Inpatient

MG Inpatient

MG/0.3ML Inpatient

MG/0.5ML Inpatient

MG/0.5ML Inpatient

MG/0.7ML Inpatient

MG/2ML Inpatient

MG/AMP Inpatient

MG/INJ Inpatient

MG/ML Inpatient

MG/SYRINGE Inpatient

MG/UNT Inpatient

MG/VIAL Inpatient

MIC/0.6ML Inpatient

MIC/1.5ML Inpatient

MIC/VIL Inpatient

MIL Inpatient

MIL/ML Inpatient

MILLION UNT/SYR Inpatient


PNU/ML Inpatient

UNT Inpatient

UNT/0.1ML Inpatient

UNT/0.2ML Inpatient

UNT/0.5ML Inpatient

UNT/0.6ML Inpatient

UNT/AMP Inpatient

UNT/ML Inpatient

UNT/TEST Inpatient

UNT/VIL Inpatient

VIL Inpatient

mgI/ml Inpatient

INJ,SOLN,SA MG/ML Inpatient

INJ,SUSP GM/VIAL Inpatient

MCG/ML Inpatient

MG/ML Inpatient

MIL/ML Inpatient


UNT/0.5ML Inpatient

UNT/1.2ML Inpatient

UNT/ML Inpatient

INJ,SUSP,SA MG Inpatient


User Manual

MG/ML Inpatient

INJ,SUSP-DRY,SA MG Inpatient

MG/VIAL Inpatient

INJ/IMPLANT MG Inpatient

INSERT,CONT REL MG Inpatient

MG/CAP Inpatient

INSERT,CONT REL,OPH MG/UNT Inpatient

INSERT,VAG MG Inpatient

LIQUID GM Inpatient

MEQ/15ML Inpatient

MG Inpatient

MG/15ML Inpatient

MG/5ML Inpatient

MG/GTT Inpatient

MG/ML Inpatient

LIQUID,ORAL GM Inpatient

GM/10ML Inpatient

GM/UNT Inpatient

MEQ/15ML Inpatient

MG Inpatient

MG/0.6ML Inpatient

MG/15ML Inpatient

MG/2.5ML Inpatient

MG/4ML Inpatient

MG/5ML Inpatient

MG/MIN Inpatient

MG/ML Inpatient

UNT/0.1ML Inpatient

UNT/ML Inpatient

LOZENGE MCG Inpatient

MG Inpatient

UNT Inpatient

OPHTHALMIC,CRC MG/UNT Inpatient

PELLET MG Inpatient

POWDER GM Inpatient

GM/1.7GM Inpatient

GM/5GM Inpatient

GM/9GM Inpatient

GM/BAG Inpatient

GM/BTL Inpatient

GM/CUP Inpatient

GM/PKT Inpatient

MG Inpatient

UNT/VIL Inpatient

POWDER,ORAL GM Inpatient

GM/5GM Inpatient


User Manual

GM/CUP Inpatient

GM/PKG Inpatient

MG/GM Inpatient

POWDER,TOP GM Inpatient

UNT/GM Inpatient

PWDR,EFFERVSC MEQ/PKT Inpatient

PWDR,RENST-ORAL CAL/ML Inpatient

GM Inpatient

GM/5GM Inpatient

GM/BTL Inpatient

GM/PKG Inpatient

GM/PKT Inpatient

GM/UNT Inpatient

MEQ/PKT Inpatient

MG/5ML Inpatient

MG/ML Inpatient

MG/PKG Inpatient

MG/PKT Inpatient

UNT/5ML Inpatient

RING,VAG MG Inpatient

SOLN MG/5ML Inpatient

MG/ML Inpatient

MIL Inpatient

MIL/ML Inpatient

UNT/ML Inpatient

SOLN,CONC MG/5ML Inpatient

MG/ML Inpatient

SOLN,INHL MG/5ML Inpatient

MG/ML Inpatient

SOLN,IRRG MG/ML Inpatient

SOLN,NASAL MCG/SPRAY Inpatient

MG/ML Inpatient

UNT/SPRAY Inpatient

SOLN,ORAL GM/ML Inpatient

MEQ/15ML Inpatient

MEQ/5ML Inpatient

MG Inpatient

MG/0.5ML Inpatient

MG/0.5ML Inpatient


MG/20ML Inpatient

MG/5ML Inpatient

MG/7.5ML Inpatient ...................................................................................................................................... MG/ML Inpatient

MIL/ML Inpatient

UNT/ML Inpatient


User Manual

SOLN,RTL MG/ML Inpatient

SOLN,SPRAY,NASAL MCG/SPRAY Inpatient

MG/SPRAY Inpatient

UNT/ML Inpatient

SUPP,RTL MG Inpatient

SUPP,VAG GM Inpatient

MG Inpatient

SUPPOSITORY MCG Inpatient

SUSP GM/5ML Inpatient

GM/60ML Inpatient

MG/15ML Inpatient

MG/5ML Inpatient

MG/ML Inpatient

UNT/ML Inpatient

SUSP,INTRATHECAL MG/ML Inpatient

SUSP,ORAL MCG/ML Inpatient

MG/15ML Inpatient

MG/5ML Inpatient

MG/ML Inpatient

UNT/ML Inpatient

SUSP,RTL GM/60ML Inpatient

SYRINGE UNT Inpatient

SYRUP GM/15ML Inpatient

GM/5ML Inpatient

MEQ/5ML Inpatient

MG/15ML Inpatient

MG/5ML Inpatient

MG/ML Inpatient

SYRUP,ORAL MG/5ML Inpatient

TAB GM Both

GR Both

MCG Both

MEQ Both

MG Both

MG/5ML Inpatient

MG/DAY Inpatient

UNT Both

TAB,BUCC,SA MG Both

TAB,BUCCAL MG Both

TAB,CHEWABLE GM Both

MG Both

TAB,EC GM Both

GR Both

MEQ Both

MG Both

UNT Both


User Manual

TAB,EFFERVSC MEQ Both

MG Both

TAB,ORAL MCG Both

MG Both

UNT Both

TAB,ORAL DISINTEGRATING MG Both

TAB,RAPID DISINTEGRATE MG Both

TAB,SA GM Both

MEQ Both

MG Both

TAB,SOLUBLE MG Both

TAB,SUBLINGUAL MG Both

TAB,VAG MG Both

UNT Both

TAMPON MG Inpatient

TAPE MCG/SQCM Inpatient

TINCTURE MG/5ML Inpatient

MG/ML Inpatient

TROCHE MG Inpatient

WAFER GM Inpatient

MG Inpatient


User Manual

Appendix B Original Drug Text File Entries Combinations

The National Formulary Restriction Text is the original text exported with the DRUG TEXT file

(#51.7) and automatically linked to the Drug File entries based on the VA Product match. No

Orderable Item file entries were automatically linked with the DRUG TEXT file (#51.7).

DRUG TEXT file (#51.7) Entry National Formulary Restriction Text

HYPERTENSION-VA/DOD Refer to VA/DoD Hypertension treatment

guidelines

SPINAL CORD,NEUROLOGY,REHAB RESTRICTED TO SPINAL CORD

INJURY,NEUROLOGY,AND

REHABILITATION

HIV/AIDS Refer to HIV/AIDS TAG treatment

guidelines

DIABETES Refer to PBM/MAP and PBM/TAG Diabetes

treatment guidelines

CHF Refer to PBM/MAP CHF treatment

guidelines

GERD Refer to PBM/MAP GERD treatment

guidelines

PUD Refer to PBM/MAP PUD treatment

guidelines

COPD Refer to VA/DoD COPD treatment guidelines

DIHYDROPYRIDINE CALCIUM

ANTAGONISTS

Refer to PBM/MAP criteria for use of long-

acting dihydropyridine calcium antagonists

HYPERLIPIDEMIA Refer to VA/DoD Hyperlipidemia treatment

guidelines

NEUROLOGY RESTRICTED TO NEUROLOGY

SMOKING CESSATION RESTRICTED TO SMOKING CESSATION

PROGRAMS

BPH Refer to PBM/MAP benign Prostatic

Hyperplasia treatment guidelines

ATORVASTATIN Refer to PBM/MAP criteria for use of

atorvastatin

TROVAFLOXACIN Refer to PBM/MAP criteria for use of

trovafloxacin

THIAZOLIDINEDIONES Refer to PBM/MAP criteria for use of

thiazolidinediones


User Manual


LANSOPRAZOLE Refer to PBM/MAP dosing guidelines for

lansoprazole


CELECOXIB Refer to PBM/MAP criteria for use of

celecoxib

BECALPERMIN Refer to PBM/MAP criteria for use of

becalpermin

DEPRESSION Refer to PBM/MAP Depression treatment

guidelines

ALBUMIN Refer to PBM/MAP guidelines for use of

albumin

HYPERTENSION/CHF-VA/DOD-

PBM/MAP

Refer to VA/DoD Hypertension treatment

and PBM/MAP CHF treatment guidelines

HYPERTENSION/CHF/DIABETES Refer to PBM/MAP Hypertension treatment

and CHF treatment guidelines and

PBM/TAG Diabetes treatment guidelines

HYPERTENSION-PBM/MAP Refer to PBM/MAP Hypertension treatment

guidelines

REVIEW Class review in progress

HYPERTENSION/CHF-PBM Refer to PBM/MAP Hypertension treatment

and CHF treatment guidelines

ALZHEIMER'S Refer to Pharmacologic Management of

Cognitive Changes in Alzheimer's Disease

BPH/HYPERTENSION Refer to PBM/MAP benign Prostatic

Hyperplasia treatment and Hypertension

treatment guidelines


User Manual

Appendix C Administration Schedules - Spanish Translations

The Outpatient Language Modifications patch PSS*1*47 provides the functionality to print prescription labels in a language other

than English. Enabling this functionality requires setting certain flags and completing several setup steps, including populating fields

used for the Sig with equivalent terms in the specified other language. The following table provides Spanish equivalents for some of

the more common Administration Schedules.

The translations in this table may require modifications for different dialects.

ADMIN SCHEDULE OUTPATIENT EXPANSION OUTPATIENT SPANISH EXPANSION

AM DAILY IN THE MORNING DIARIAMENTE EN LA MANANA

AM-HS AT MORNING AND AT BEDTIME EN LA MANANA Y AL ACOSTARSE

AM-PM AT MORNING AND IN THE AFTERNOON EN LA MANANA Y EN LA TARDE

AM-PMI MORNING AND EVENING EN LA MANANA Y EN LA TARDE

BID TWO TIMES A DAY DOS VECES AL DIA

BID &HS TWO TIMES A DAY AND AT BEDTIME DOS VECES AL DIA Y AL ACOSTARSE

DAILY EVERY DAY DIARIAMENTE

FR-SA FRIDAY AND SATURDAY VIERNES Y SABADO

FRIDAY FRIDAY VIERNES

HS AT BEDTIME AL ACOSTARSE

MO-FR MONDAY AND FRIDAY LUNES Y VIERNES

MO-TH MONDAY AND THURSDAY LUNES Y JUEVES

MO-TU MONDAY AND TUESDAY LUNES Y MARTES

MO-TU-FR MONDAY, TUESDAY, FRIDAY LUNES, MARTES Y VIERNES

MO-TU-FR-SA MONDAY,TUESDAY,FRIDAY AND SATURDAY LUNES, MARTES, VIERNES Y SABADO

MO-TU-TH-FR-SA MONDAY,TUESDAY,THURSDAY,FRIDAY AND SATURDAY LUNES,MARTES,JUEVES,VIERNES Y SABADO

MO-TU-TH-SA MONDAY,TUESDAY,THURSDAY AND SATURDAY LUNES,MARTES,JUEVES Y SABADO

MO-TU-WE MONDAY, TUESDAY, WEDNESDAY LUNES, MARTES Y MIERCOLES

MO-TU-WE-TH MONDAY,TUESDAY,WEDNESDAY AND THURSDAY LUNES, MARTES, MIERCOLES Y JUEVES

MO-TU-WE-TH-FR MONDAY,TUESDAY,WEDNESDAY,THURSDAY AND FRIDAY LUNES, MARTES, MIERCOLES, JUEVES Y VIERNES

MO-TU-WE-TH-FR-SA MONDAY THRU SATURDAY DE LUNES A SABADO

MO-TU-WE-TH-SA MONDAY,TUESDAY,WEDNESDAY,THURSDAY AND SATURDAY LUNES, MARTES, MIERCOLES, JUEVES Y SABADO


User Manual


MO-WE MONDAY AND WEDNESDAY LUNES Y MIERCOLES

MO-WE-FR MONDAY,WEDNESDAY AND FRIDAY LUNES,MIERCOLES Y VIERNES

MO-WE-FR MONDAY,WEDNESDAY AND FRIDAY LUNES,MIERCOLES Y VIERNES

MO-WE-FR MONDAY, WEDNESDAY AND FRIDAY LUNES,MIERCOLES Y VIERNES

MO-WE-FR-SA MONDAY,WEDNESDAY,FRIDAY AND SATURDAY LUNES,MIERCOLES,VIERNES Y SABADO

MO-WE-SA MONDAY, WEDNESDAY AND SATURDAY LUNES,MIERCOLES Y SABADO

MO-WE-TH-FR MONDAY, WEDNESDAY,THURSDAY AND FRIDAY LUNES, MIERCOLES, JUEVES Y VIERNES

MONDAY MONDAY LUNES

MONTHLY MONTHLY MENSUALMENTE

NOW NOW AHORA

ONCE ONCE UNA SOLA VEZ

ONE TIME ONE-TIME UNA SOLA VEZ

PC&HS AFTER MEALS AND AT BEDTIME DESPUES DE LAS COMIDAS Y AL ACOSTARSE

PM DAILY IN THE AFTERNOON DIARIAMENTE EN LA TARDE

Q12H EVERY 12 HOURS CADA DOCE HORAS

Q12WEEKS EACH TWELVE WEEKS CADA 12 SEMANAS

Q15D EVERY 15 DAYS CADA 15 DIAS

Q1H EVERY HOUR CADA HORA



Q24H EVERY 24 HOURS CADA 24 HORAS



Q2H EVERY 2 HOURS CADA DOS HORAS

Q2MONTHS EVERY TWO MONTHS CADA DOS MESES

Q2WEEK EVERY TWO WEEKS CADA DOS SEMANAS


Q30MIN EVERY 30 MINUTES CADA 30 MINUTOS



Q3MONTHS EVERY THREE MONTHS CADA TRES MESES

Q3WEEK EVERY THREE WEEKS CADA TRES (3) SEMANAS





User Manual


Q4WEEK EVERY FOUR WEEKS CADA CUATRO (4)SEMANAS


Q5MIN EVERY 5 MINUTES CADA 5 MINUTOS





Q96H EACH 96 HOURS CADA 96 HORAS

QAM EVERY MORNING DIARIAMENTE EN LA MANANA

QD DAILY DIARIAMENTE

QD1300 EVERY DAY AT 1:00 PM CADA DIA A LA 1:00 PM

QD5 FIVE TIMES A DAY CINCO VECES AL DIA

QDAM EVERY MORNING CADA MANANA

QDHS DAILY AT BEDTIME DIARIAMENTE AL ACOSTARSE

QDI DAILY DIARIAMENTE

QDMD DAILY AT NOON DIARIAMENTE AL MEDIODIA

QDPM DAILY IN THE EVENING DIARIAMENTE EN LA TARDE

QH EVERY HOUR CADA HORA

QID FOUR TIMES A DAY CUATRO VECES AL DIA

QOD EVERY OTHER DAY UN DIA SI Y OTRO NO

QWEEK WEEKLY CADA SEMANA

SATURDAY SATURDAY SABADO

SU-FR SUNDAY AND FRIDAY DOMINGO Y VIERNES

SU-FR-SA SUNDAY,FRIDAY AND SATURDAY DOMINGO ,VIERNES Y SABADO

SU-MO-FR SUNDAY , MONDAY AND FRIDAY DOMINGO , LUNES Y VIERNES

SU-MO-TH SUNDAY,MONDAY,THURSDAY DOMINGO,LUNES Y JUEVES

SU-MO-TU SUNDAY,MONDAY AND TUESDAY DOMINGO,LUNES Y MARTES

SU-MO-TU-FR SUNDAY,MONDAY,TUESDAY AND FRIDAY DOMINGO,LUNES,MARTES Y VIERNES

SU-MO-TU-FR-SA SUNDAY,MONDAY,TUESDAY,FRIDAY,SATURDAY DOMINGO,LUNES,MARTES,VIERNES Y SABADO

SU-MO-TU-SA SUNDAY ,MONDAY, TUESDAY AND SATURDAY DOMINGO, LUNES,MARTES Y SABADO

SU-MO-TU-TH-FR SUNDAY,MONDAY,TUESDAY,THURSDAY AND FRIDAY DOMINGO,LUNES,MARTES,JUEVES Y VIERNES

SU-MO-TU-TH-FR-SA SUNDAY,MONDAY,TUESDAY,THURSDAY,FRIDAY AND SATURDAY DOMINGO,LUNES,MARTES,JUEVES,VIERNES Y SABADO

SU-MO-TU-TH-SA SUNDAY,MONDAY,TUESDAY,THURSDAY AND SATURDAY DOMINGO,LUNES,MARTES,JUEVES Y SABADO

SU-MO-TU-WE-FR SUNDAY,MONDAY,TUESDAY,WEDNESDAY,FRIDAY DOMINGO,LUNES,MARTES,MIERCOLES Y VIERNES

SU-MO-TU-WE-FR-SA SUNDAY,MONDAY,TUESDAY,WEDNESDAY,FRIDAY,SATURDAY DOMINGO,LUNES,MARTES,MIERCOLES,VIERNES Y SABADO


User Manual


SU-MO-TU-WE-TH SUNDAY, MONDAY,TUESDAY,WEDNESDAY,THURSDAY DOMINGO,LUNES,MARTES,MIERCOLES Y JUEVES

SU-MO-TU-WE-TH-FR SUNDAY THRU FRIDAY DE DOMIGO A VIERNES

SU-MO-TU-WE-TH-SA SUNDAY,MONDAY,TUESDAY,WEDNESDAY,THURSDAY,SATURDAY DOMINGO,LUNES,MARTES,MIERCOLES,JUEVES Y SABADO

SU-MO-WE SUNDAY,MONDAY AND WEDNESDAY DOMINGO,LUNES Y MIERCOLES

SU-MO-WE-FR SUNDAY,MONDAY,WEDNESDAY AND FRIDAY DOMINGO,LUNES,MIERCOLES Y VIERNES

SU-MO-WE-FR-SA SUNDAY,MONDAY,WEDNESDAY,FRIDAY AND SATURDAY DOMINGO,LUNES,MIERCOLES,VIERNES Y SABADO

SU-MO-WE-TH-FR SUNDAY,MONDAY,WEDNESDAY,THURSDAY AND FRIDAY DOMINGO,LUNES,MIERCOLES,JUEVES Y VIERNES

SU-MO-WE-TH-FR-SA SUNDAY,MONDAY AND WEDNESDAY THRU SATURDAY DOMINGO,LUNES Y DE MIERCOLES A SABADO

SU-SA SUNDAY AND SATURDAY DOMINGO Y SABADO

SU-TH-FR-SA SUNDAY ,THURSDAY , FRIDAY AND SATURDAY DOMINGO, JUEVES, VIERNES Y SABADO

SU-TU-SA SUNDAY , TUESDAY AND SATURDAY DOMINGO,MARTES Y SABADO

SU-TU-TH SUNDAY,TUESDAY,THURSDAY DOMINGO,MARTES Y JUEVES

SU-TU-TH-FR-SA SUNDAY,TUESDAY,THURSDAY,FRIDAY AND SATURDAY DOMINGO,MARTES,JUEVES,VIERNES Y SABADO

SU-TU-TH-SA SUNDAY,TUESDAY,THURSDAY AND SATURDAY DOMINGO,MARTES,JUEVES Y SABADO

SU-TU-TH-SA SUNDAY,TUESDAY,THURSDAY AND SATURDAY DOMINGO,MARTES,JUEVES Y SABADO

SU-TU-WE-TH-FR-SA SUNDAY AND TUESDAY THRU SATURDAY DOMINGO Y DE MARTES A SABADO

SU-TU-WE-TH-SA SUNDAY,TUESDAY,WEDNESDAY,THURSDAY AND SATURDAY DOMINGO,MARTES,MIERCOLES,JUEVES Y SABADO

SU-WE SUNDAY AND WEDNESDAY DOMINGO Y MIERCOLES

SU-WE-FR SUNDAY,WEDNESDAY AND FRIDAY DOMINGO ,MIERCOLES Y VIERNES

SUNDAY SUNDAY DOMINGO

TH THURSDAY JUEVES

TH-FR THURSDAY, FRIDAY JUEVES Y VIERNES

TH-SA THURSDAY AND SATURDAY JUEVES Y SABADO

THURSDAY THURSDAY JUEVES

TID THREE TIMES A DAY TRES VECES AL DIA

TID &HS THREE TIMES A DAY AND AT BEDTIME TRES VECES AL DIA Y AL ACOSTARSE

TID 1/2HR-AC THREE TIMES A DAY, HALF HOUR BEFORE MEALS TRES VECES AL DIA, MEDIA HORA ANTES DE LAS COMIDAS

TID 1/2HR.AC&HS HALF HOUR BEFORE MEALS AND AT BEDTIME MEDIA HORA ANTES DE LAS COMIDAS Y AL ACOSTARSE

TID 1HR-PC&HS ONE HOUR AFTER MEALS AND AT BEDTIME UNA HORA DESPUES DE LAS COMIDAS Y AL ACOSTARSE

TU TUESDAY MARTES

TU-FR TUESDAY AND FRIDAY MARTES Y VIERNES

TU-SA TUESDAY AND SATURDAY MARTES Y SABADO

TU-SA TUESDAY AND SATURDAY MARTES Y SABADO

TU-TH TUESDAY AND THURSDAY MARTES Y JUEVES

TU-TH-FR TUESDAY, THURSDAY AND FRIDAY MARTES, JUEVES Y VIERNES


User Manual


TU-TH-SA TUESDAY,THURSDAY AND SATURDAY MARTES ,JUEVES Y SABADO

TU-TH-SA TUESDAY-THURSDAY-SATURDAY MARTES ,JUEVES Y SABADO

TU-WE-FR-SA TUESDAY,WEDNESDAY,FRIDAY,SATURDAY MARTES,MIERCOLES,VIERNES Y SABADO

TU-WE-TH TUESDAY,WEDNESDAY AND THURSDAY MARTES,MIERCOLES Y JUEVES

TUESDAY TUESDAY MARTES

WE WEDNESDAY MIERCOLES

WE-FR WEDNESDAY AND FRIDAY MIERCOLES Y VIERNES

WE-SA WEDNESDAY AND SATURDAY MIERCOLES Y SABADO

WE-TH-FR WEDNESDAY, THURSDAY AND FRIDAY MIERCOLES, JUEVES Y VIERNES

WE-TH-FR-SA WEDNESDAY THRU SATURDAY DE MIERCOLES A SABADO

WEDNESDAY WEDNESDAY MIERCOLES

WEEKLY WEEKLY SEMANALMENTE


User Manual



User Manual

Appendix D Dosage Forms - Spanish Translations




the more common dosage forms.


DOSAGE FORM VERB VERB IN SPANISH PREPOSITION

PREPOSITION IN SPANISH NOUN NOUN IN SPANISH

ADAPTER USE UTILIZAR AS DIRECTED SEGUN INDICADO

AEROSOL USE HACER FOR POR SPRAY(S) ATOMIZACION(ES)

AEROSOL,ORAL INHALE HACER BY POR PUFF(S) INHALACION(ES)

AEROSOL,RTL INSERT INSERTAR INTO EN EL APPLICATOR(S) APLICADOR(ES)

AEROSOL,TOP APPLY APLICAR TO PARA SPRAY(S) ATOMIZACION(ES)

AEROSOL,VAG APPLY APLICAR TO EN LA SPRAY(S) ATOMIZACION(ES)

APPLICATOR USE UTILIZAR AS DIRECTED SEGUN INDICADO

BAG USE UTILIZAR AS DIRECTED SEGUN INDICADO

BANDAGE USE UTILIZAR AS DIRECTED SEGUN INDICADO

BAR,CHEWABLE CHEW MASTICAR BY POR BAR BARRA

BAR,TOP USE UTILIZAR AS DIRECTED SEGUN INDICADO

BEADS,TOP USE USAR AS DIRECTED SEGUN INDICADO

BELT USE UTILIZAR AS DIRECTED SEGUN INDICADO

BLOCK USE UTILIZAR AS DIRECTED SEGUN INDICADO

CAP,EC TAKE TOMAR BY POR CAPSULE(S) CAPSULA(S)

CAP,INHL USE USAR BY PARA CAPSULE(S) CAPSULA(S)

CAP,ORAL TAKE TOMAR BY POR CAPSULE(S) CAPSULA(S)

CAP,SA TAKE TOMAR BY POR CAPSULE(S) CAPSULA(S)

CAP,SPRINKLE TAKE TOMAR BY POR CAPSULE(S) CAPSULA(S)


User Manual

DOSAGE FORM VERB

VERB IN

SPANISH PREPOSITION

PREPOSITION IN

SPANISH NOUN NOUN IN SPANISH

CAP,SPRINKLE,SA TAKE TOMAR BY POR CAPSULE(S) CAPSULA(S)

CONVEX INSERT USE UTILIZAR AS DIRECTED SEGUN INDICADO

CREAM APPLY APLICAR TO EN THIN FILM UNA CAPA FINA

CREAM,ORAL APPLY APLICAR TO EN LA THIN FILM UNA CAPA FINA

CREAM,OTIC APPLY APLICAR TO EN THIN FILM UNA CAPA FINA

CREAM,RTL INSERT INSERTAR INTO POR EL APPLICATORFUL APLICADOR LLENO

CREAM,TOP APPLY APLICAR TO EN A THIN FILM UNA CAPA FINA

CREAM,VAG INSERT INSERTAR INTO EN LA ONE APLICATORFUL UN APLICADOR LLENO

CRYSTAL USE UTILIZAR AS DIRECTED SEGUN INDICADO

DENTAL CONE USE UTILIZAR

DEVICE USE USAR AS INDICATED SEGUN INDICADO

DIAPHRAGM USE UTILIZAR AS DIRECTED SEGUN INDICADO

DISK USE USAR AS DIRECTED SEGUN INDICADO

DOUCHE USE USAR INTO EN LA AS DIRECTED SEGUN INDICADO

DRAIN USE UTILIZAR AS DIRECTED SEGUN INDICADO

DRESSING APPLY APLICAR TO EN AS DIRECTED SEGUN INDICADO

DRESSING,TOP APPLY APLICAR TO EN AS DIRECTED SEGUN INDICADO

DROPS,ORAL TAKE TOMAR BY POR DROP(S) GOTA(S)

ELIXIR TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

EMULSION TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

EMULSION,TOP APPLY APLICAR TO EN AS DIRECTED SEGUN INDICADO

ENEMA INSERT INSERTAR INTO EN EL AS DIRECTED SEGUN INDICADO

ENEMA,RTL INSERT INSERTAR INTO EN EL AS DIRECTED SEGUN INDICADO

EXTRACT ADMINISTER ADMINISTRAR ML(S) MILILITRO

FACEPLATE USE UTILIZAR AS DIRECTED SEGUN INDICADO

FILM APPLY APLICAR OVER SOBRE AS DIRECTED SEGUN INDICADO

FILM,CONT REL APPLY APLICAR OVER SOBRE PATCH PARCHO

FLANGE CAP USE UTILIZAR AS DIRECTED SEGUN INDICADO

FLUFF USE UTILIZAR AS DIRECTED SEGUN INDICADO

FLUID EXTRACT TAKE TOMAR BY POR ML(S) MILILITRO(S)

FOAM,TOP USE UTILIZAR AS DIRECTED


User Manual

DOSAGE FORM VERB

VERB IN

SPANISH PREPOSITION

PREPOSITION IN


GAS INHALE INHALAR SEGUN INDICADO SEGUN INDICADO

GAUZE USE USAR

GEL USE USAR TO EN LA THIN FILM CAPA FINA

GEL,DENT APPLY APLICAR FOR PARA AS DIRECTED SEGUN INDICADO

GEL,NASAL APPLY APLICAR TO EN AS DIRECTED SEGUN INDICADO

GEL,OPH APPLY APLICAR TO EN INCH PULGADA(S)

GEL,TOP APPLY APLICAR TO EN THIN FILM CAPA FINA

GLOVE USE USAR AS DIRECTED SEGUN INDICADO

GRAFT,TOP USE UTILIZAR AS DIRECTED SEGUN INDICADO

GRANULES USE USAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

GRNL,EFFERVSC TAKE TOMAR TEASPOONFUL(S) CUCHARADITA(S)

GRNL,RCNST-ORAL TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

GUM,CHEWABLE CHEW MASTICAR IN EN LA PIECE(S) PIEZA(S)

IMPLANT INJECT INYECTAR AS DIRECTED SEGUN INDICADO

INHALANT USE USAR BY POR PUFF(S) INHALACION(ES)

INHALATIONS USE USAR BY POR PUFF(S) INHALACION(ES)

INHALER USE USAR BY POR PUFF(S) INHALACION(S)

INHL,NASAL USE USAR SPRAY(S) ATOMIZACION(ES)

INHL,ORAL USE USAR BY POR PUFF(S) INHALACION(ES)

INJ ADMINISTER INJECTAR ADMINISTRAR

INJ (IN OIL) INJECT INJECTAR POR

INJ,CONC INJECT INJECTAR POR

INJ,CONC, W/BUF INJECT INJECTAR POR

INJ,CONC-SOLN INJECT INJECTAR POR

INJ,FROZEN INJECT INJECTAR POR

INJ,LYPHL INJECT INJECTAR POR

INJ,PWDR INJECT INJECTAR POR

INJ,REPOSITORY INJECT INJECTAR POR

INJ,SOLN INJECT INJECTAR

INJ,SOLN (IN OIL) INJECT INJECTAR POR

INJ,SOLN,LA INJECT INJECTAR POR

INJ,SOLN,SA INJECT INJECTAR POR


User Manual

DOSAGE FORM VERB

VERB IN

SPANISH PREPOSITION

PREPOSITION IN


INJ,SUSP INJECT INJECTAR POR

INJ,SUSP (IN OIL) INJECT INJECTAR POR

INJ,SUSP,SA INJECT INJECTAR POR

INJ,SUSP-DRY,SA INJECT INJECTAR POR

INJ/IMPLANT PLACE PONER POR IMPLANT(S) IMPLANTE(S)

INSERT,CONT REL INSERT INSERTAR IN EN AS DIRECTED SEGUN INDICADO

INSERT,CONT REL,OPH INSERT INSERTAR IN EN AS DIRECTED SEGUN INDICADO

INSERT,VAG INSERT INSERTAR TO EN LA AS DIRECTED SEGUN INDICADO

IRRIGATION SET USE UTILIZAR AS DIRECTED SEGUN INDICADO

IRRIGATION SLEEVE USE UTILIZAR AS DIRECTED SEGUN INDICADO

IRRIGATOR USE UTILIZAR AS DIRECTED SEGUN INDICADO

IUD INSERT INSERTAR BY POR VIA AS DIRECTED SEGUN INDICADO

JELLY APPLY APLICAR TO EN THIN FILM UNA CAPA FINA

JELLY,NASAL APPLY APLICAR IN EN THIN FILM UNA CAPA FINA

JELLY,TOP APPLY APLICAR TO EN THIN FILM UNA CAPA FINA

JELLY,VAG INSERT INSERTAR INTO DENTRO DE LA APPLICATORFUL(S) APLICADOR LLENO

KIT USE USAR AS DIRECTED SEGUN INDICADO

LANCET USE USAR AS DIRECTED SEGUN INDICADO

LENS,HARD PLACE PONER INTO EN AS DIRECTED SEGUN INDICADO

LENS,SOFT PLACE PONER INTO EN AS DIRECTED SEGUN INDICADO

LINIMENT APPLY APLICAR TO EN AS DIRECTED SEGUN INDICADO

LIQUID TAKE TOMAR BY POR LA TEASPOONFUL(S) CUCHARADITA(S)

LIQUID(SF) TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

LIQUID,AEROSOL APPLY APLICAR FOR PARA SPRAY(S) ATOMIZACION(ES)

LIQUID,DENT APPLY APLICAR TO PARA AS DIRECTED SEGUN INDICADO

LIQUID,INHL USE UTILIZAR INHALATION(S) INHALACIONES

LIQUID,OPH INSTIL ECHAR FOR PARA DROP(S) GOTA(S)

LIQUID,ORAL TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

LIQUID,OTIC INSTILL ECHAR IN EN DROP(S) GOTA(S)

LIQUID,RTL APPLY APLICAR IN EN

LIQUID,TOP APPLY APLICAR TO PARA AS DIRECTED

LOTION APPLY APLICAR TO EN AS DIRECTED SEGUN INDICADO


User Manual

DOSAGE FORM VERB

VERB IN

SPANISH PREPOSITION

PREPOSITION IN


LOTION,TOP APPLY APLICAR TO EN AS DIRECTED SEGUN INDICADO

LOZENGE DISSOLVE DISOLVER IN EN LA LOZENGE TABLETA

MASK USE UTILIZAR AS INDICATED SEGUN INDICADO

MISCELLANEOUS USE USAR AS DIRECTED SEGUN INDICADO

MOUTHWASH USE UTILIZAR FOR PARA TEASPOONFUL(S) CUCHARADITA(S)

NEEDLE USE UTILIZAR AS DIRECTED SEGUN INDICADO

OIL TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

OIL,TOP APPLY APLICAR FOR PARA AS DIRECTED SEGUN INDICADO

OINT,DENT APPLY APLICAR FOR PARA USO THIN FILM UNA CAPA FINA

OINT,OPH APPLY APLICAR TO A THIN FILM UNA CAPA FINA

OINT,RTL INSERT INSERTAR TO AL ONE APLICATORFUL UN APLICADOR LLENO

OINT,TOP APPLY APLICAR TO PARA A THIN FILM UNA CAPA FINA

OINTMENT INSERT INSERTAR FOR PARA USO THIN LAYER UNA CAPA FINA

OPH USE UTILIZAR DROP(S) GOTA(S)

OPH IRR USE USE TO EN IRRIGATION(S) IRRIGACION(ES)

OPHTHALMIC,CRC PLACE PONER INTO EN THIN FILM CAPA FINA

PAD USE UTILIZAR AS DIRECTED SEGUN INDICADO

PAD,TOP USE UTILIZAR AS DIRECTED SEGUN INDICADO

PASTE APPLY APLICAR FOR PARA THIN FILM UNA CAPA FINA

PATCH APPLY APLICAR TO EN PATCH PARCHO

PELLET INSERT INSERTAR BY POR PELLET(S) BOLITA(S)

PILL TAKE TOMAR BY POR PILL(S) PILDORA(S)

POUCH USE UTILIZAR AS DIRECTED SEGUN INDICADO

POWDER USE USAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

POWDER,AEROSOL USE UTILIZAR FOR PARA SPRAY(S) ATOMIZACION(ES)

POWDER,ORAL TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

POWDER,RTL

DISOLVE

AND INSERT

DISOLVER E

INSERTAR BY POR ENEMA(S) ENEMA(S)

POWDER,SPRAY APPLY APLICAR FOR PARA SPRAY(S) ATOMIZACION(ES)

POWDER,TOP APPLY APLICAR TO PARA PACKAGE(S) SOBRE(S)


User Manual

DOSAGE FORM VERB

VERB IN

SPANISH PREPOSITION

PREPOSITION IN


PUDDING TAKE TOMAR BY POR

THE CONTENT OF A

CAN

EL CONTENIDO DE UNA

LATA

PWDR,EFFERVSC

DISOLVE

AND TAKE

DISOLVER Y

TOMAR BY POR TABLESPOONFUL(S) CUCHARADA(S)

PWDR,RENST-ORAL TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

RING,VAG USE UTILIZAR BY POR LA AS DIRECTED SEGUN INDICADO

RINSE,ORAL USE UTILIZAR FOR PARA TEASPOONFUL(S) CUCHARADITA(S)

SET USE UTILIZAR AS DIRECTED SEGUN INDICADO

SET,INFUSION USE UTILIZAR AS DIRECTED SEGUN INDICADO

SHAMPOO SHAMPOO

LAVAR EL

CABELLO AS DIRECTED SEGUN INDICADO

SOAP/DETERGENT WASH AREA LAVAR AREA AS DIRECTED SEGUN INDICADO

SOLN USE USAR BY POR

SOLN,CONC TAKE TOMAR BY POR

SOLN,INHL USE UTILIZAR

IN NEBULIZER

FOR

EN NEBULIZADOR

POR MILLILITER(S) MILILITRO(S)

SOLN,IRRG USE UTILIZAR FOR PARA

SOLN,NASAL USE ECHAR EN DROP(S) GOTA(S)

SOLN,OPH INSTILL ECHAR DROP(S) GOTA(S)

SOLN,OPH IRRG USE UTILIZAR FOR PARA

SOLN,ORAL TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

SOLN,OTIC INSTILL ECHAR IN PARA DROP(S) GOTA(S)

SOLN,RTL INSTILL INSERTAR BY POR EL CONTENT(S) CONTENIDO

SOLN,SPRAY,NASAL USE UTILIZAR IN EN SPRAY(S) ATOMIZACION(ES)

SOLN,TOP APPLY APLICAR TO PARA

SPIRIT USE UTILIZAR

SPONGE USE UTILIZAR AS DIRECTED SEGUN INDICADO

SPRAY,TOP SPRAY ROCIAR FOR PARA AS DIRECTED SEGUN INDICADO

STOMA CAP USE UTILIZAR AS DIRECTED SEGUN INDICADO

STRIP USE UTILIZAR STRIP AS DIRECTED TIRILLA SEGUN INDICADO


User Manual

DOSAGE FORM VERB

VERB IN

SPANISH PREPOSITION

PREPOSITION IN


STRIP,OPH USE UTILIZAR IN EN STRIP AS DIRECTED TIRILLA SEGUN INDICADO

SUPP,RTL INSERT INSERTAR BY POR EL SUPPOSITORY SUPOSITORIO

SUPP,VAG INSERT INSERTAR IN EN LA SUPPOSITORY SUPOSITORIO

SUPPOSITORY INSERT INSERTAR INTO EN SUPPOSITORY SUPOSITORIO

SUSP TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

SUSP(SF) TAKE TOMAR BY POR TABLESPOONFUL(S) CUCHARADA(S)

SUSP,INTRATHECAL INJECT INJECTAR BY POR VIA

SUSP,OPH INSTILL ECHAR IN EN DROP(S) GOTA(S)

SUSP,ORAL TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

SUSP,OTIC INSTILL ECHAR IN EN DROP(S) GOTA(S)

SUSP,RTL INSERT INSERTAR IN EN EL CONTENT(S) CONTENIDO

SUSP,SA TAKE TOMAR BY POR TABLESPOONFUL(S) CUCHARADA(S)

SWAB,TOP APPLY APLICAR BY EN AS DIRECTED SEGUN INDICADO

SYRINGE USE UTILIZAR AS DIRECTED SEGUN INDICADO

SYRINGE/NDL USE UTILIZAR AS DIRECTED SEGUN INDICADO

SYRUP TAKE TOMAR BY POR TEASPOONFUL(S) CUCHARADITA(S)

SYRUP,ORAL TAKE TOMAR BY POR TABLESPOONFUL(S) CUCHARADA(S)

SYRUP,SR TAKE TOMAR BY POR TABLESPOONFUL(S) CUCHARADA(S)

TAB TAKE TOMAR BY POR TABLET(S) TABLETA(S)

TAB,BUCC,SA PLACE PONER BETWEEN ENTRE TABLET(S) TABLETA(S)

TAB,BUCCAL PLACE PONER BETWEEN ENTRE TABLET(S) TABLETA(S)

TAB,CHEWABLE

CHEW AND

SWALLOW

MASTICAR Y

TRAGAR TABLET(S) TABLETA(S)

TAB,CHEWG GUM CHEW MASTICAR PIECE(S) PIEZA(S)

TAB,CR TAKE TOMAR BY POR TABLET(S) TABLETA(S)

TAB,EC TAKE TOMAR BY POR TABLET(S) TABLETA(S)

TAB,EC (DEL RELEASE) TAKE TOMAR TABLET TABLETA

TAB,EC,SA TAKE TOMAR BY POR TABLET(S) TABLETA(S)

TAB,EFFERVSC DISSOLVE DISOLVER

IN WATER

AND TAKE BY

EN AGUA Y

TOMAR POR TABLET(S) TABLETA(S)


User Manual

DOSAGE FORM VERB

VERB IN

SPANISH PREPOSITION

PREPOSITION IN


TAB,EFFERVSC,TOP

DISSOLVE IN

WATER

DISOLVER EN

AGUA

AND APPLY

TO Y APLICAR EN TABLET(S) TABLETA(S)

TAB,LA TAKE TOMAR BY POR TABLET(S) TABLETA(S)

TAB,ORAL TAKE TOMAR BY POR TABLET(S) TABLETA(S)

TAB,ORAL

DISINTEGRATING PLACE PONER BY POR TABLET(S) TABLETA(S)

TAB,ORAL/VAG

TAB,RAPID DISINTEGRATE PLACE PONER BY POR TABLET(S) TABLETA(S)

TAB,SA TAKE TOMAR BY POR TABLET(S) TABLETA(S)

TAB,SOLUBLE

DISSOLVE

AND APPLY

DISOLVER Y

APLICAR IN EN TABLET(S) TABLETA(S)

TAB,SUBLINGUAL DISSOLVE DISOLVER TABLET(S) TABLETA(S)

TAB,TEST USE USAR FOR TESTING PARA PRUEBA TABLET(S) TABLETA(S)

TAB,VAG INSERT INSERTAR IN POR TABLET(S) TABLETA(S)

TAMPON INSERT INSERTAR IN POR AS DIRECTED SEGUN INDICADO

TAPE USE USAR AS DIRECTED SEGUN INDICADO

TEST STRIP USE USAR FOR TESTING PARA PRUEBA STRIP AS DIRECTED TIRILLA SEGUN INDICADO

TINCTURE TAKE TOMAR BY POR

TINCTURE,TOP APPLY APLICAR TO PARA AS DIRECTED SEGUN INDICADO

TROCHE DISSOLVE DISOLVER BY POR TROCHE(S) TROCISCO(S)

WAFER USE USAR AS DIRECTED SEGUN INDICADO

WAFER,TOP USE USAR AS DIRECTED SEGUN INDICADO


User Manual

Appendix E Local Possible Dosages - Spanish Translations The Outpatient Language Modifications patch PSS*1*47 provides the functionality to print prescription labels in a language other



the more common local possible dosages.


LOCAL POSSIBLE DOSAGE SPANISH LOCAL DOSAGE

0.05 MILLILITERS 0.05 MILILITROS





0.25 MILLILITER 0.25 MILILITRO


0.4 MILLILITER OF 120MCG/0.5ML 0.4 MILILITRO DE 120MCG/0.5ML


0.5 MILLIGRAMS 0.5 MILIGRAMOS

0.5 MILLILITER 0.5 MILILITRO




0.9 MILLIGRAM 0.9 MILIGRAMO

1 AMPULE 1 AMPOLLETA

1 RING AS DIRECTED 1 ANILLO SEGUN INDICADO

1 APPLICATORFUL 1 APLICADOR LLENO

1 SPRAY 1 ATOMIZACION

1 CAPSULE 1 CAPSULA

1 TABLESPOONFUL 1 CUCHARADA


User Manual


1 TEASPOONFUL 1 CUCHARADITA

1 ENEMA 1 ENEMA

1 ENEMA AS DIRECTED 1 ENEMA SEGUN INDICADO

1 DROP 1 GOTA

1 GRAM 1 GRAMO

1 IMPLANT 1 IMPLANTE

1 PUFF 1 INHALACION

1 MILLIGRAM 1 MILIGRAMO

1 MILLILITER 1 MILILITRO

1 PATCH 1 PARCHO

1 PIECE 1 PIEZA

1 INCH 1 PULGADA

1 AS DIRECTED 1 SEGUN INDICADO

1 PACKET 1 SOBRE

1 SUPPOSITORY 1 SUPOSITORIO

1 TABLET 1 TABLETA

1 STRIP AS DIRECTED 1 TIRILLA SEGUN INDICADO

1 TROCHE 1 TROCISCO

1.2 MILLION UNITS 1.2 MILLONES DE UNIDADES

1.25 GRAMS 1.25 GRAMOS



10 DROPS 10 GOTAS

10 MILLIGRAMS 10 MILIGRAMOS

10 UNITS 10 UNIDADES


1000MG 1000 MILIGRAMOS


10MG (0.2 MILLILITERS) 10MG (0.2 MILILITROS)

10MG (1 MILLILITER) 10MG (1 MILILITRO)

12.5 MILLIGRAMS (0.5 MILLILITER) 12.5 MILIGRAMOS (0.5 MILILITRO)

1200MG 1200 MILIGRAMOS


User Manual




150000 UNITS (0.3ML) 150000 UNIDADES (0.3ML)

2 SPRAYS 2 ATOMIZACIONES

2 CAPSULES 2 CAPSULAS

2 TABLESPOONFULS 2 CUCHARADAS

2 TEASPOONFULS 2 CUCHARADITAS

2 DROPS 2 GOTAS

2 GRAMS 2 GRAMOS

2 PUFFS 2 INHALACIONES


2 MILLILITERS 2 MILILITROS

2 PIECES 2 PIEZAS

2 INCH 2 PULGADAS

2 PACKETS 2 SOBRES

2 TABLETS 2 TABLETAS

2.4 MILLION UNITS 2.4 MILLONES DE UNIDADES




200 MCG(4 MU)(1ML) 200 MCG(4 MU)(1ML)





20MG (2 MILLILITERS) 20MG (2 MILILITROS)






3 DROPS 3 GOTAS


User Manual




3 MILLION UNITS 3 MILLONES DE UNIDADES









4 TEASPOONFULS 4 CUCHARADITAS

4 LEVEL TEASPOONFULS 4 CUCHARADITAS AL RAS

4 DROPS 4 GOTAS

4 GRAMS 4 GRAMOS





400 MGS (4 TEASPOONFULS) 400 MGS (4 CUCHARADITAS)



4MG (40 MILLILITERS) 4MG (40 MILILITROS)

5 GRAMS 5 GRAMOS

5 MGS (1.67 MILLILITERS) 5 MGS (1.67 MILILITROS)


5 UNITS 5 UNIDADES







User Manual




600 MGS(2 TABLESPOONFULS) 600 MGS(2 CUCHARADAS)

600,000 UNITS 600,000 UNIDADES

75 MILLIGRAMS ( 3 MILLILITERS) 75 MILIGRAMOS ( 3 MILILITROS )





LOCAL CARE CUIDADO LOCAL

DISSOLVE WITH 0.7 ML STERILE WATER AND INJECT XX ML DISOLVER CON 0.7ML DE AGUA ESTERIL E INYECTAR XX ML

TWO APPLICATORSFUL DOS APLICADORES LLENOS

TWO AND A HALF TEASPOONFULS DOS Y MEDIA CUCHARADITAS

THE CONTENT OF THE BOTTLE EL CONTENIDO DE LA BOTELLA

THE CONTENT OF ONE GALLON EL CONTENIDO DE UN GALON

THE CONTENT OF ONE PACKET EL CONTENIDO DE UN SOBRE

THE CONTENT OF ONE AMPULE EL CONTENIDO DE UNA AMPOLLETA

THE CONTENT OF ONE BOTTLE EL CONTENIDO DE UNA BOTELLA

THE CONTENT OF ONE CAN EL CONTENIDO DE UNA LATA

HALF TEASPOONFUL MEDIA CUCHARADITA

HALF INCH MEDIA PULGADA

HALF TABLET MEDIA TABLETA

HALF MILLILITER MEDIO MILILITRO

AS DIRECTED SEGUN INDICADO

THE WHOLE CONTENT TODO EL CONTENIDO

1 APPLICATOR UN APLICADOR

ONE APPLICATORFUL UN APLICADOR LLENO

A THIN FILM UNA CAPA FINA

ONE AND A HALF TEASPOONFUL UNA CUCHARADITA Y MEDIA

A SMALL AMOUNT UNA PEQUENA CANTIDAD

A SMALL AMOUNT UNA PEQUENA CANTIDAD

ONE INCH UNA PULGADA


User Manual


1 AS DIRECTED UNA SEGUN INDICADO

ONE AND A HALF TEASPOONFUL UNA Y MEDIA CUCHARADITA

ONE AND A HALF INCH UNA Y MEDIA PULGADA


User Manual

Appendix F Medication Instructions - Spanish Translations

The Outpatient Language Modifications patch PSS*1*47 provides the functionality to print prescription labels in a language other than

English. Enabling this functionality requires setting certain flags and completing several setup steps, including populating fields used for the

Sig with equivalent terms in the specified other language. The following table provides Spanish equivalents for some of the more common

medication instructions that can be entered in the new OTHER MEDICATION INSTRUCTIONS file.


MED INSTRUCTIONS EXPANSION SPANISH EXPANSION

828 AT 8AM, 2PM AND 8PM A LAS 8AM, 2PM Y 8PM

838 8AM, 3PM, AND 8PM 8AM, 3PM Y 8PM

&L AND LUNCH Y EL ALMUERZO

() (AT 8AM, 3PM AND AT BEDTIME) A LAS 8AM, 3PM Y AL ACOSTARSE

(12) (NOT MORE THAN 12 A DAY) (NO MAS DE 12 AL DIA)

(3) (NO MORE THAN 3 A DAY) (NO MAS DE 3 AL DIA)


(5) (NO MORE THAN 5 A DAY) (NO MAS DE 5 AL DIA)



1,2HPC 1 HR.BEFORE OR 2 HRS. AFTER MEALS 1 HORA ANTES O 2 HORAS DESPUES DE LAS COMIDAS

13H ONE AND THREE HOURS UNA Y TRES HORAS

13HPC ONE & THREE HOURS AFTER MEALS UNA Y TRES HORAS DESPUES DE LAS COMIDAS

15BB 15 MINUTES BEFORE BATH 15 MINUTOS ANTES DEL BANO

1ATO SPRAY ONCE UNA ATOMIZACION

1D INSTILL ONE DROP ECHAR UNA GOTA

1DAY THE FIRST DAY EL PRIMER DIA

1HAC ONE HOUR BEFORE MEALS UNA HORA ANTES DE LAS COMIDAS

1HPC 1 HOUR AFTER MEALS 1 HORA DESPUES DE LAS COMIDAS

1HRPCHS ONE HOUR AFTER MEALS AND AT BEDTIME UNA HORA DESPUES DE LAS COMIDAS Y AL ACOSTARSE

1HS AND 1 AT BEDTIME Y UNA AL ACOSTARSE

1I ONE INHALATION UNA INHALACION


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1PM AT 1:OO PM A LA 1:00 PM

1V AT ONE TIME DE UNA SOLA VEZ

23D 2-3 TIMES A DAY 2-3 VECES AL DIA

2ATO SPRAY TWICE DOS ATOMIZACIONES

2D INSTILL 2 DROPS ECHAR 2 GOTAS

2DAY THE SECOND DAY EL SEGUNDO DIA

2HS AND 2 AT BEDTIME Y DOS AL ACOSTARSE

2I TWO INHALATIONS DOS INHALACIONES

30BBM 30 MINUTES BEFORE BREAKFAST AND EVENING MEAL 30 MINUTOS ANTES DEL DESAYUNO Y LA CENA

30M 30 MINUTES 30 MINUTOS

34D 3-4 TIMES A DAY 3-4 VECES AL DIA


3HS AND 3 AT BEDTIME Y TRES AL ACOSTARSE

3I THREE INHALATIONS TRES INHALACIONES

3PA NO MORE THAN 3 DOSES PER ATTACK MAXIMO 3 DOSIS POR ATAQUE


4HS AND FOUR AT BEDTIME Y CUATRO AL ACOSTARSE

4I FOUR INHALATIONS CUATRO INHALACIONES


5PM AT 5:00 PM A LAS 5:00 PM


7AM AT 7:00 AM A LAS 7:00 AM


A1 APPLY 1 INCH TO THE CHEST APLICAR 1 PULGADA EN EL PECHO

A1P APPLY ONE PATCH APLICAR UN PARCHO

A2 APPLY 2 INCHES TO THE CHEST APLICAR 2 PULGADAS EN EL PECHO

A8 AT 8PM ONLY A LAS 8:00 PM SOLAMENTE

AA AVOID ALCOHOL WHILE TAKING THIS MEDICINE EVITE USO DE BEBIDAS ALCOHOLICAS

AAA AVOID ANTACIDS USE WITH THIS MEDICATION EVITAR USO DE ANTIACIDOS JUNTO CON EL MEDICAMENTO

AB AFTER BREAKFAST DESPUES DEL DESAYUNO

ABM AFTER EACH BOWEL MOVEMENT DESPUES DE CADA EVACUACION

ABT AT BREAKFAST TIME A LA HORA DEL DESAYUNO

AC BEFORE MEALS ANTES DE LAS COMIDAS

ACD AT ONSET OF HEADACHE AL COMENZAR EL DOLOR DE CABEZA


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AD INTO RIGHT EAR EN OIDO DERECHO

ADA AFFECTED AFECTADA

ADACID ADJUST INTAKE OF POTENTIALLY ACID ASH FOOD AJUSTAR INGESTA DE ALIMENTOS ACIDOS

ADBASIC ADJUST INTAKE OF POTENTIALLY BASIC FOOD AJUSTAR INGESTA DE ALIMENTOS ALCALINOS

ADM ADMINISTER ADMINISTRAR

ADO AFFECTED AFECTADO

AES AVOID EXPOSURE TO SUNLIGHT EVITAR EXPOSICION A LA LUZ SOLAR

AF AFFECTED FOOT PIE AFECTADO

AFA INTO AFFECTED EAR EN OIDO AFECTADO

AFE ONTO AFFECTED EYE EN OJO AFECTADO

AGF AVOID GRAPEFRUIT JUICE EVITE USO DE JUGO DE TORONJA

AH AFFECTED HAND MANO AFECTADA

AHS AND AT BEDTIME Y AL ACOSTARSE

AI IN SELECTED AREA EN AREA INDICADA

ALBM AFTER EACH LOOSE BOWEL MOVEMENT DESPUES DE CADA EVACUACION BLANDA

ALENDRO BEFORE YOU TAKE ANY FOOD,BEVERAGE OR MEDICINE ANTES DE INGERIR ALIMENTO,BEBIDA O MEDICINA-

AMN IN THE MORNING AND AT NOON EN LA MANANA Y AL MEDIODIA

AMOXI TAKE 2 TWICE A DAY AFTER BREAKFAST AND SUPPER TOME 2 VECES AL DIA DESPUES DE DESAYUNO Y CENA

AOP APPLY ONE PATCH ON AFFECTED AREA APLICAR UN PARCHO EN AREA INDICADA

AP APPLY APLICAR

AS3 INSTILL THE CONTENTS OF ONE AMPUL IN THE NEBULIZER ECHAR EL CONTENIDO DE UNA AMPULA EN EL NEBULIZADOR

ASU AFTER SUPPER DESPUES DE LA COMIDA

ATC AROUND THE CLOCK DIA Y NOCHE

AU IN BOTH EARS EN CADA OIDO

AVCAFF LIMIT OR AVOID CAFFEINE INTAKE EVITE O LIMITE TOMAR CAFE

AW ALTERNATING WITH ALTERNANDO CON

BARIUM STARTING ON COMENZANDO EN

BB BEFORE BREAKFAST ANTES DEL DESAYUNO

BEM BEFORE THE EVENING MEAL ANTES DE LA CENA

BID 2 TIMES A DAY 2 VECES AL DIA

BIDAP TWICE A DAY IN MORNING AND EVENING 2 VECES AL DIA EN LA MANANA Y LA TARDE

BIW TWO TIMES A WEEK 2 VECES EN SEMANA

BM BETWEEN MEALS ENTRE COMIDAS

BMHS BETWEEN MEALS AND AT BEDTIME ENTRE COMIDAS Y AL ACOSTARSE


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C68H EVERY 6-8 HOURS CADA 6-8 HORAS

CAP CAPSULE CAPSULA

CH EVERY HOUR CADA HORA

CLARI TAKE 1 TWO TIMES A DAY AFTER BREAKFAST AND SUPPER TOME UNA 2 VECES AL DIA DESPUES DE DESAYUNO Y CENA

CLOTRI1 DISSOLVE ONE IN MOUTH FOR 10-15 MINUTES & SWALLOW DISOLVER UNA EN LA BOCA POR 10-15 MINUTOS Y TRAGAR

CLOTRI2 DISSOLVE TWO IN MOUTH FOR 10-15 MINUTES & SWALLOW DISOLVER DOS EN LA BOCA POR 10-15 MINUTOS Y TRAGAR

CN IN THE EVENING CADA NOCHE

CP CHEST PAIN DOLOR EN EL PECHO

CS CHEW AND SWALLOW MASTICAR Y TRAGAR

CS1 CHEW AND SWALLOW ONE MASTICAR Y TRAGAR UNA

CS2 CHEW AND SWALLOW TWO MASTICAR Y TRAGAR DOS

CTS CHANGE TASTE CAMBIA SENSITIVIDAD AL GUSTO

D DROP GOTA

D1 TO SOLVE 1 DISOLVER UNA

D2 TO SOLVE 2 DISOLVER DOS

D25SS DILUTE 0.25CC IN 5CC OF SALINE SOLUTION DILUIR 0.25 CC EN 5 CC DE SOLUCION SALINA

D25W DILUTE 0.25CC IN 5CC OF DISTILLED WATER DILUIR 0.25 CC EN 5 CC DE AGUA DESTILADA

D34W DURING THE THIRD AND FOURTH WEEK DURANTE LA TERCERA Y CUARTA SEMANA



D3SS DILUTE 0.3CC IN 3CC SOD. CHLORIDE DILUIR 0.3 CC EN 3 CC DE SOLUCION SALINA

D3W DILUTE 0.3CC IN 3CC DISTILLED WATER DILUIR 0.3 CC EN 3 CC DE AGUA DESTILADA



D5SS DILUTE 0.5CC IN 5CC OF SOD. CHLORIDE DILUIR 0.5 CC EN 5 CC DE SOLUCION SALINA


D8A MIXED IN 8 OUNCES OF WATER DISUELTA EN 8 ONZAS DE AGUA

D8J MIXED IN 8 OUNCES OF JUICE DISUELTA EN 8 ONZAS DE JUGO

DA RIGHT DERECHA

DBS BEGINNING THE DAY BEFORE THE STUDY COMENZANDO EL DIA ANTES DEL ESTUDIO

DC1S CONTENTS OF 1 PACKET IN 8 1/2 OZ OF WATER AND TAKE EL CONTENIDO DE UN SOBRE EN 8 1/2 ONZAS DE AGUA Y TOMAR

DI DISSOLVE DISOLVER

DIL DILUTED DILUIDA

DILO DILUTED DILUIDO


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DILOS DILUTED DILUIDOS

DILS DILUTED DILUIDAS

DIS DISSOLVED DISUELTA

DISS DISSOLVED DISUELTAS

DNCC DON'T CRUSH OR CHEW NO TRITURAR NI MASTICAR

DNCCS DON'T CHEW,CRUSH OR SPLIT NO TRITURAR, MASTICAR NI PARTIR

DO RIGHT DERECHO

DOME1 ONE TABLET DISSOLVED IN 1 LITER OF WATER DISOLVER 1 TABLETA EN 1 LITRO DE AGUA

DOME2 ONE OR TWO TABLETS DISSOLVED IN 1 LITER OF WATER DISOLVER 1 O 2 TABLETAS EN 1 LITRO DE AGUA

DSM DISSOLVE SLOWLY IN THE MOUTH DISOLVER LENTAMENTE EN LA BOCA

DTF MUST BE DOCUMENTED ON TREATMENT FORM 10-2970C DEBE SER DOCUMENTADO EN LA FORMA DE TRATAMIENTO 10-2970C

E1 TAKE ONE CAN DAILY TOMAR EL CONTENIDO DE UNA LATA DIARIAMENTE

E2 TAKE ONE CAN TWICE A DAY TOMAR EL CONTENIDO DE UNA LATA DOS VECES AL DIA

E3 TAKE ONE CAN 3 TIMES A DAY TOMAR EL CONTENIDO DE UNA LATA 3 VECES AL DIA

E4 TAKE ONE CAN 4 TIMES A DAY TOMAR EL CONTENIDO DE UNA LATA 4 VECES AL DIA

ED SPACE ALL EYE DROPS AT LEAST 5 MINUTES APART ESPACIAR LAS GOTAS AL MENOS CON 5 MINUTOS DE DIFERENCIA

ENEMA FOR THE STUDY OF PARA EL ESTUDIO DE

EOW EVERY OTHER WEEK UNA SEMANA SI Y OTRA NO

EP14 MIX 1/2 CUP IN 6 OZ OF COLD WATER AND TAKE DISOLVER 1/2 TAZA EN 6OZ DE AGUA PARA TOMAR

EPM TO PALMS EN LA PALMA DE LAS MANOS

EPP TO SOLES EN LA PLANTA DE LOS PIES

EU EXTERNAL USE USO EXTERNO

EXT EXTERNALLY EXTERNAMENTE

F FOR PARA

F10 FOR TEN DAYS POR DIEZ DIAS

F12 FOR 12 DAYS POR 12 DIAS



F1D FOR ONE DAY POR UN DIA




F2D FOR TWO DAYS POR DOS DIAS



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F3D FOR THREE DAYS POR TRES DIAS


F4W FOR 4 WEEKS POR 4 SEMANAS

F5 FOR FIVE DAYS POR CINCO DIAS


F60 (MEDICATIONS FOR 60 DAYS) (MEDICAMENTOS PARA 60 DIAS)


F8 FOR EIGHT DAYS POR OCHO DIAS

F90 (MEDICATIONS FOR 90 DAYS) (MEDICAMENTOS PARA 90 DIAS)

FA FOR HEARTBURN PARA ACIDEZ

FAC FOR A COLD PARA CATARRO

FAL FOR ALLERGY PARA ALERGIA

FANE FOR ANEMIA PARA ANEMIA

FANX FOR ANXIETY PARA LA ANSIEDAD

FAP FOR ABDOMINAL PAIN PARA DOLOR ABDOMINAL

FAR FOR ARTHRITIS PARA ARTRITIS

FAS FOR ASTHMA PARA ASMA

FBC TO AVOID BLOOD COAGULATION PARA EVITAR COAGULOS EN LA SANGRE

FBO FROM BOTTLE DEL FRASCO

FBP FOR BLOOD PRESSURE PARA LA PRESION

FBS FOR SITZ BATH PARA BANOS DE ASIENTO

FC FOR COUGH PARA LA TOS

FCHOL FOR CHOLESTEROL PARA COLESTEROL

FCIR FOR CIRCULATION PARA LA CIRCULACION

FCON FOR CONSTIPATION PARA EL ESTRENIMIENTO

FCP FOR CHEST PAIN PARA DOLOR EN EL PECHO

FD FOR DIARRHEA PARA DIARREA

FDEP FOR DEPRESSION PARA DEPRESION

FDI FOR DIZZINESS PARA MAREOS

FDIAB FOR DIABETES PARA DIABETES

FDRY FOR DRYNESS PARA RESEQUEDAD

FED FOR EDEMA PARA EDEMA

FEL FOR EYELIDS PARA LOS PARPADOS

FENTANYL APPLY ONE PATCH AS INDICATED EVERY 72 HOURS APLICAR UN PARCHO EN AREA INDICADA CADA 72 HORAS


User Manual


FF FOR FLUIDS PARA FLUIDOS

FFI FOR FUNGI INFECTION PARA INFECCION DE HONGO

FG FOLLOWED BY A GLASS OF WATER SEGUIDO DE UN VASO DE AGUA

FGA FOR GASTRITIS PARA GASTRITIS

FGLAU FOR GLAUCOMA PARA GLAUCOMA

FGOUT FOR GOUT PARA GOTA

FH FOR HEART PARA EL CORAZON

FHA FOR HEADACHE PARA DOLOR DE CABEZA

FHBP FOR HIGH BLOOD PRESSURE PARA LA PRESION ALTA

FHG FOLLOWED BY 1/2 GLASS OF WATER SEGUIDO DE 1/2 VASO DE AGUA

FI FOR INFECTION PARA INFECCION

FID 5 TIMES A DAY 5 VECES AL DIA

FII TO INJECT INSULIN PARA INYECTAR INSULINA

FIN FOR INSOMNIA PARA INSOMNIO

FINC FOR INCONTINENCE PARA INCONTINENCIA

FINFEC FOR INFECTION PARA INFECCION

FINFL FOR INFLAMATION PARA LA INFLAMACION

FIR FOR IRRITATION PARA IRRITACION

FIT FOR ITCHING PARA PICOR

FJP FOR JOINT PAIN PARA DOLOR EN LAS COYUNTURAS

FLC FOR LEG CRAMPS PARA CALAMBRES EN LAS PIERNAS

FLCU FOR LOCAL CARE OF THE ULCER PARA CUIDADO LOCAL DE LA ULCERA

FLED FOR LEGS EDEMA PARA EDEMA DE LAS PIERNAS

FLEET THE NIGHT BEFORE THE STUDY AND 1 THE NEXT MORNING LA NOCHE ANTES DEL ESTUDIO,UNA LA MANANA SIGUIENTE

FME FOR MEMORY PARA LA MEMORIA

FMEN FOR MENTAL HEALTH CONDITION PARA CONDICION MENTAL

FMIG FOR MIGRAINE PARA MIGRANA

FMS FOR MUSCLE SPASM PARA ESPASMO MUSCULAR

FN FOR NERVES PARA LOS NERVIOS

FNA FOR NAUSEA PARA NAUSEA

FNC FOR NASAL CONGESTION PARA CONGESTION NASAL

FP FOR PAIN PARA DOLOR

FPARK FOR PARKINSON'S DISEASE PARA PARKINSON

FPF FOR PAIN AND/OR FEVER PARA DOLOR Y/O FIEBRE


User Manual


FPM DOCUMENT ON VAF 672-241-10-97-118 PAIN FLOW SHEET DOCUMENTAR EN "VAF 672-241-10-97-118 PAIN FLOW SHEET"

FPROS FOR PROSTATE PARA LA PROSTATA

FPSO FOR PSORIASIS PARA PSORIASIS

FR FOR REST PARA DESCANSAR

FREF FOR REFLUX PARA EL REFLUJO

FSB FOR SHORTNESS OF BREATH PARA RESPIRACION ENTRECORTADA

FSEI FOR SEIZURES PARA CONVULSIONES

FSI FOR SINUS PARA SINUSITIS

FSL FOR SLEEP PARA DORMIR

FSP FOR SEVERE PAIN PARA DOLOR FUERTE

FST FOR STOMACH PARA EL ESTOMAGO

FSW FOR SWELLING PARA HINCHAZON

FTG FOR TRIGLYCERIDES PARA LOS TRIGLICERIDOS

FTYR FOR THYROIDS PARA TIROIDES

FUP FOR URINE PROTEINS PARA LAS PROTEINAS EN LA ORINA

FUT FOR GLUCOSE URINE TESTING PARA PRUEBA DE AZUCAR EN LA ORINA

FVIT AS VITAMIN OR SUPPLEMENT COMO VITAMINA O SUPLEMENTO

FW FOR WHEEZING PARA PITO ASMATICO

GA FOR GARGLES PARA HACER GARGARAS

GOLY ADD LUKEWARM DRINKING WATER TO THE FILL MARK, ANADIR AGUA TIBIA HASTA LA MARCA INDICADA

H HOUR HORA

H2 DISTILLED WATER AGUA DESTILADA

HS AT BEDTIME AL ACOSTARSE

I INSERT INSERTAR

I1J IN 1 GLASS OF JUICE EN UN VASO DE JUGO

I1W IN 1 GLASS OF WATER EN UN VASO DE AGUA

IA LEFT IZQUIERDA

IE IN EARS EN LOS OIDOS

IGW IN A GLASS OF WATER OR JUICE EN UN VASO DE AGUA O JUGO

IJ IN JUICE EN JUGO

IM INTRAMUSCULAR INTRAMUSCULAR

IMF DOCUMENT IN VAF 672-244-12-97-11G DOCUMENTAR EN LA FORMA:VAF 672-244-12-97-11G

INJ INJECT INYECTAR

INO IN NOSTRILS EN FOSAS NASALES


User Manual


INS INSTILL ECHAR

INTRON DISOLVE IN 5 ML OF DILUENT, AND INJECT DISOLVER CON 5 ML DE DILUYENTE E INYECTAR

IO LEFT IZQUIERDO

IV FOR INTRAVENOUS USE POR VIA INTRAVENOSA

IW IN WATER EN AGUA

IWJ IN WATER OR JUICE EN AGUA O JUGO

KWELL APPLY TO BODY (FROM NECK DOWN), APLICAR DEL CUELLO HACIA ABAJO

L8H LEAVE FOR 8 HOURS AND REMOVE WELL DEJAR POR 8 HORAS Y REMOVER BIEN

LANSO TAKE ONE TWICE A DAY 30 MIN BEFORE BREAKFAST AND A TOME 1 DOS VECES AL DIA 30 MIN ANTES DEL DESAYUNO Y AL ACOSTARSE

LCC TO WASH SCALP LAVAR CUERO CABELLUDO

LE INTO LEFT EAR EN OIDO IZQUIERDO

LPD USE LOW PROTEIN DIET USE DIETA BAJA EN PROTEINAS

LUPRON DISSOLVE WITH 1 ML OF DILUENT AND INJECT DISOLVER CON 1 ML DE DILUYENTE E INYECTAR

M8WJ MIXED IN 8 OUNCES OF WATER OR JUICE DISUELTA EN 8 ONZAS DE AGUA O JUGO

MIN MINUTES MINUTOS

MOU MILLIONS OF UNITS MILLONES DE UNIDADES

MP16 MIX 4 LEVEL TABLESPOONS IN 8 OZ OF MILK AND TAKE MEZCLAR 4 CUCHARADAS RASAS EN 8 ONZAS DE LECHE Y TOMAR

MW USE FOR MOUTH WASH USAR PARA LAVADOS BUCALES

N AT NOON AL MEDIODIA

NATE DO NOT LIE DOWN FOR 30 MIN. AFTER YOU TAKE IT NO SE RECUESTE POR 30 MIN DESPUES DE TOMARLO

NG Flush the line BEFORE and AFTER med. adm. LIMPIAR LA LINEA ANTES Y DESPUES DE LA ADMINISTRACION

NHS DO NOT TAKE AT BEDTIME NO TOME ANTES DE ACOSTARSE

NS

NV FOR NAUSEA AND/OR VOMITING PARA NAUSEAS Y/O VOMITOS

OAD ONCE A DAY UNA VEZ AL DIA

OD ONTO RIGHT EYE EN OJO DERECHO

ONF ON FEET EN LOS PIES

ONR ON RASH EN ERUPCION

ONS ON SKIN EN LA PIEL

ONSC ON SCALP EN CUERO CABELLUDO

OS ONTO LEFT EYE EN OJO IZQUIERDO

OU ONTO EACH EYE EN CADA OJO

PC AFTER MEALS DESPUES DE LAS COMIDAS

PC&HS AFTER MEALS AND AT BEDTIME DESPUES DE LAS COMIDAS Y AL ACOSTARSE


User Manual


PC&HS PRN AFTER MEALS AND AT BEDTIME IF NECESSARY DESPUES DE LAS COMIDAS Y AL ACOSTARSE SI ES NECESARIO

PHOSPHO (45 ML) DILUTED IN 4 OUNCES OF WATER (45 ML) DILUIDOS EN 4 ONZAS DE AGUA

PLA PLACE PONER

PO BY MOUTH POR BOCA

PRN AS NEEDED CUANDO SEA NECESARIO

PUDM TAKE 2 TABLESPOONS 7 TIMES A DAY (EVERY 2-4HOURS) TOMAR 2 CUCHARADAS 7 VECES AL DIA (CADA 2-4 HORAS)

PUDR TAKE 3 TABLESPOONS 7 TIMES A DAY (EVERY 2-4 HOURS) TOMAR 3 CUCHARADAS 7 VECES AL DIA (CADA 2-4 HORAS)

PYLORI THEN TAKE ONE DAILY FOR 15 DAYS (EMPTY STOMACH) LUEGO TOME UNA DIARIA POR 15 DIAS (ESTOMAGO VACIO)

Q EVERY CADA

Q1-2H EVERY 1-2 HOURS CADA 1-2 HORAS


Q12W EVERY 12 WEEKS CADA 12 SEMANAS

Q15M EVERY 15 MINUTES CADA 15 MINUTOS




Q2W EVERY TWO WEEKS CADA 2 SEMANAS

Q34H EVERY 3-4 HOURS CADA 3-4 HORAS



Q46H EVERY 4-6 HOURS CADA 4-6 HORAS

Q4D EVERY FOUR DAYS CADA 4 DIAS


Q5D EVERY FIVE DAYS CADA 5 DIAS

Q5M EVERY 5 MINUTES CADA 5 MINUTOS


Q7D EVERY SEVEN DAYS CADA 7 DIAS

Q8H EVERY EIGHT HOURS CADA 8 HORAS

QAM EVERY MORNING CADA MANANA

QAMHS IN THE MORNING AND AT BEDTIME EN LA MANANA Y AL ACOSTARSE

QD DAILY DIARIA

QDAM DAILY IN THE MORNING DIARIAMENTE EN LA MANANA

QDHS DAILY AT BEDTIME DIARIAMENTE EN LA NOCHE

QDM DAILY DIARIAMENTE


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QDPM DAILY IN THE AFTERNOON DIARIAMENTE EN LA TARDE

QDS DAILY DIARIAS

QID 4 TIMES A DAY 4 VECES AL DIA

QIDAC 4 TIMES A DAY BEFORE MEALS & AT BEDTIME 4 VECES AL DIA, ANTES DE LAS COMIDAS Y AL ACOSTARSE

QIDHS FOUR TIMES A DAY AND AT BEDTIME 4 VECES AL DIA Y AL ACOSTARSE

QIDPC FOUR TIMES A DAY AFTER MEALS & AT BEDTIME 4 VECES AL DIA DESPUES DE LAS COMIDAS Y AL ACOSTARSE

QM MONTHLY CADA MES

QOD EVERY OTHER DAY UN DIA SI Y OTRO NO

QPM EVERY AFTERNOON CADA TARDE

QW EVERY WEEK CADA SEMANA

R IN RECTUM POR VIA RECTAL

RC REPEAT CYCLE AS DIRECTED REPETIR EL CICLO SEGUN INDICADO

SAL SALINE SOLUTION SOLUCION SALINA

SC SUBCUTANEOUSLY POR VIA SUBCUTANEA

SD ON STUDY DAY EL DIA DEL ESTUDIO

SEN IF NEEDED SI ES NECESARIO

SFN IF NECESSARY SI FUERA NECESARIO

SL UNDER THE TONGUE DEBAJO DE LA LENGUA

SLC UNDER TONGUE FOR CHEST PAIN DEBAJO DE LA LENGUA PARA DOLOR EN EL PECHO

SO TO SOAK REMOJAR

SODA 7:00PM DAY BEFORE STUDY, 5:00AM THE DAY OF STUDY 7:00PM DIA ANTES DE ESTUDIO, 5:00AM DIA DE ESTUDIO

SP SPARINGLY LIGERAMENTE

SPR SPRAY ATOMIZAR

SS SWISH & SWALLOW HACER BUCHES Y TRAGAR

ST IMMEDIATELY INMEDIATAMENTE

SUP SUPPOSITORY SUPOSITORIO

T TAKE TOMAR

T1 TAKE ONE TOME UNA

T1/2 TAKE ONE HALF TOMAR MEDIA

T1/2TAB TAKE ONE HALF TABLET TOMAR MEDIA TABLETA

T1/2TBL TAKE ONE HALF TABLESPOONFUL TOMAR MEDIA CUCHARADA

T1/4 TAKE ONE QUARTER TOMAR UN CUARTO

T1/4T TAKE ONE FOURTH TABLET TOMAR UN CUARTO DE TABLETA

T10 TAKE TEN TOMAR DIEZ


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T11/2T TAKE ONE AND A HALF TABLET TOMAR UNA Y MEDIA TABLETA

T11/2TBL TAKE ONE AND A HALF TABLESPOONFUL TOMAR UNA CUCHARADA Y MEDIA

T12 TAKE ONE OR TWO TOMAR UNA O DOS

T1E TAKE ONE ENVELOPE TOMAR EL CONTENIDO DE UN SOBRE

T2 TAKE TWO TOME DOS

T23 TAKE TWO OR THREE TOMAR DOS O TRES

T3 TAKE THREE TOME TRES

T4 TAKE FOUR TOME CUATRO

T5 TAKE FIVE TOME CINCO

T6 TAKE SIX TOME SEIS

T7 TAKE SEVEN TOME SIETE

T8 TAKE EIGHT TOME OCHO

T8W TAKE WITH 8 OZ OF WATER TOMAR CON 8 ONZAS DE AGUA

TAA TO AFFECTED AREA EN AREA AFECTADA

TAB TABLET TABLETA

TABS TABLETS TABLETAS

TBL TABLESPOONFUL CUCHARADA

TBLS TABLESPOONFULS CUCHARADAS

TC1L TAKE CONTENT OF ONE CAN TOMAR EL CONTENIDO DE UNA LATA

TEA TEASPOONFUL CUCHARADITA

TEAS TEASPOONFULS CUCHARADITAS

TELY TAKE THE ENTIRE CONTENTS AS DIRECTED TOMAR EL CONTENIDO EN 4 HORAS SEGUN INDICADO

TESTO INJECT 1 ML INTRAMUSCULAR EVERY 2 WEEKS INYECTAR 1 ML INTRAMUSCULAR CADA 2 SEMANAS

TGEN TO GENITAL AREA EN AREA GENITAL

TGLU IN THE GLUTEUS EN LAS NALGAS

TIA TO INGUINAL AREA EN AREA INGUINAL

TID 3 TIMES A DAY 3 VECES AL DIA

TIDAC 3 TIMES A DAY BEFORE MEALS 3 VECES AL DIA ANTES DE LAS COMIDAS

TIDHS 3 TIMES A DAY AND AT BEDTIME 3 VECES AL DIA Y AL ACOSTARSE

TIDPC 3 TIMES DAILY AFTER MEALS 3 VECES AL DIA DESPUES DE LAS COMIDAS

TIW THREE TIMES A WEEK 3 VECES EN SEMANA

TLEX TO LOWER EXTREMITIES EN LAS EXTREMIDADES INFERIORES

TLFO TO LEFT FOOT EN EL PIE IZQUIERDO

TLUEX TO LOWER & UPPER EXTREMITIES EN LAS EXTREMIDADES SUPERIORES E INFERIORES


User Manual


TR TO RELAX PARA RELAJARSE

TRFO TO RIGHT FOOT EN EL PIE DERECHO

TTH TO THE HANDS EN LAS MANOS

TUEX TO UPPER EXTREMITIES A LAS EXTREMIDADES SUPERIORES

TW TO WASH PARA LAVAR

TWAA TO WASH AFFECTED AREA PARA LAVAR AREA AFECTADA

TWH TO WASH HAIR PARA LAVAR EL CABELLO

U UNIT UNIDADES

UAH UPON ARRIVAL HOME AL LLEGAR A LA CASA

UD AS DIRECTED SEGUN INDICADO

UFB USE FOR BATHING USAR PARA BANARSE

UFD USE FOR WET DRESSING USAR PARA COMPRESAS

UFI USE FOR INHALATIONS USAR PARA INHALACIONES

UUD USE AS DIRECTED USAR SEGUN INDICADO

VIDEX TAKE 2 CHEWED, CRUSHED OR DISPENSED IN WATER TOME 2 MASTICADAS,MOLIDAS O DISPERSAS EN AGUA

W. WITH CON

WA WHILE AWAKE MIENTRAS ESTE DESPIERTO

WF WITH FOOD CON ALIMENTO

WL WITH LUNCH CON EL ALMUERZO

WM WITH MEALS CON COMIDAS

WMK WITH MILK OR FATTY MEALS CON LECHE O PRODUCTOS ALTOS EN GRASA

WOMK WITHOUT DAIRY/IRON FORTIFIED PRODUCTS SIN PRODUCTOS QUE CONTENGA LECHE O HIERRO


User Manual



User Manual

Appendix G Medication Routes – Spanish Translations




the more common medication routes.


MEDICATION ROUTE OUTPATIENT EXPANSION SPANISH OUTPATIENT EXPANSION

BLADDER IRRIGATION BLADDER IRRIGATION IRRIGACION DE VEJIGA

BOTH EARS BOTH EARS AMBOS OIDOS

BOTH EYES BOTH EYES EN AMBOS OJOS

BUCCAL CHEEK AND GUM UNTIL DISSOLVED LA QUIJADA Y LA ENCIA HASTA QUE SE DISUELVA

CHEWABLE CHEWABLE MASTICAR Y TRAGAR

DEEP IM DEEP INTRAMUSCULAR INTRAMUSCULAR PROFUNDO

DENTAL DENTAL USE USO DENTAL

GARGLE GARGLE GARGARAS

GASTROSTOMY GASTROSTOMY GASTROSTOMIA

GASTROSTOMY TUBE GASTROSTOMY TUBE TUBO DE GASTROSTOMIA

INFILTRATION INFILTRATION INFILTRACION

INHALATION INHALATION INHALACION

INHALATION NASAL NASAL INHALATION

INHALATION ORAL ORAL INHALATION

INTRA-ARTERIAL INTRA-ARTERIAL VIA INTRA ARTERIAL

INTRA-ARTICULAR INTRA-ARTICULAR INTRA-ARTICULAR

INTRA-DYALISIS INTRA-DYALISIS INTRA-DYALISIS

INTRABURSAL INTRABURSAL INTRABURSAL

INTRACARDIAC INTRACARDIAC INTRACARDIACO

INTRACAVITY INTRACAVITY DENTRO DE LA CAVIDAD


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INTRADERMAL INTRADERMAL DENTRO DE LA PIEL

INTRAFOLLICULAR INTRAFOLLICULAR DENTRO DEL FOLICULO

INTRALESIONAL LOCALIZED LESION DENTRO DE LA LESION

INTRAMUSCULAR INTRAMUSCULAR VIA INTRAMUSCULAR

INTRAOCULAR INTRAOCULAR DENTRO DEL OJO

INTRAPERITONEAL INTRAPERITONEAL USE VIA INTRAPERITONEAL

INTRAPLEURAL INTRAPLEURAL INTRAPLEURAL

INTRASYNOVIAL INTRASYNOVIAL INTRASYNOVIAL

INTRATHECAL INTRATHECAL INTRATECAL

INTRATHORACIC INTRATHORACIC DENTRO DEL TORAX

INTRATRACHEAL INTRATRACHEAL USE DENTRO DE LA TRAQUEA

INTRAUTERINE INTRAUTERINE DENTRO DEL UTERO

INTRAVENOUS FOR INTRAVENOUS USE VIA INTRAVENOSA

INTRAVESICAL INTRAVESICAL INTRAVESICAL

IRRIGATION IRRIGATION IRRIGACION

IRRIGATION OPHTHALMIC OPHTHALMIC IRRIGATION IRRIGACION OFTAMICA

IV PIGGYBACK INTRAVENOUS USE VIA INTRAVENOSA

JEJUNOSTOMY JEJUNOSTOMY JEJUNOSTOMIA

JEJUNOSTOMY TUBE JEJUNOSTOMY TUBE TUBO DE JEJUNOSTOMIA

LEFT EAR LEFT EAR OIDO IZQUIERDO

LEFT EYE LEFT EYE EN OJO IZQUIERDO

MOUTHWASH MOUTHWASH ENJUAGUE BUCAL

NASAL IN NOSTRILS LA NARIZ

NASAL IN NOSTRILS LA NARIZ

NG TUBE NASOGASTRIC TUBE TUBO NASOGASTRICO

OPHTHALMIC FOR OPHTHALMIC USE PARA USO OFTALMICO

ORAL MOUTH BOCA

ORAL INHALATION ORAL INHALATION INHALACION ORAL

ORAL TOPICAL ORAL TOPICAL USE USO TOPICO EN LA BOCA

OTIC AFFECTED EAR USO OTICO

PERCUTANEOUS THROUGH THE SKIN A TRAVES DE LA PIEL

RECTAL RECTUM RECTO


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RIGHT EAR RIGHT EAR OIDO DERECHO

RIGHT EYE RIGHT EYE EN OJO DERECHO

SUBCUTANEOUS SUBCUTANEOUSLY VIA SUBCUTANEA

SUBLINGUAL UNDER THE TONGUE DEBAJO DE LA LENGUA

TOPICAL AFFECTED AREA AREA AFECTADA

TRANSDERMAL TRANSDERMAL A TRAVES DE LA PIEL

TRANSURETHRAL TRANSURETHRAL TRANSURETRAL

URETHRAL URETHRAL URETRA

VAGINAL VAGINA VAGINA


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User Manual

Index

A ADditives File, 164

Administration Schedule File Report, 144 Administration Schedules, Spanish Translations, 223 Appendix A

See Convertible Dosage Form/Unit Combinations, 213 Appendix B

See Original Drug Text File Entries Combinations, 221 Appendix C

See Administration Schedules, Spanish Translations, 223

Appendix D See Dosage Forms, Spanish Translations, 229

Appendix E See Local Possible Dosages, Spanish Translations, 237

Appendix F See Medication Instructions, Spanish Translations, 243

Appendix G See Medication Routes, Spanish Translations, 257

B

BCMA prompts DSPLY ON IVP/IVPB TAB IN BCMA?, 90 PROMPT FOR INJ. SITE IN BCMA, 90

C Check Drug Interaction, 168 Check PEPS Services Setup, 160

Check Vendor Database Link, 159 CMOP Mark/Unmark (Single drug) option, 3, 6 Complex Local Possible Dosages, 200

Convertible Dosage Form/Unit Combinations, 213 Creating the Sig, 200

D

DEA Special Handling Code, 34 Default Med Route For OI Report, 100 Dispense Drug Fields, 166

Dispense Drug/ATC Set Up, 166 Dispense Drug/Orderable Item Maintenance, 115 Dosage Form Enter/Edit, 8

Dosage Forms, Spanish Translations, 229 Dosages, 7, 180 Drug Enter/Edit, 31

Drug Enter/Edit option, 6 Drug Text Enter/Edit, 130 Drug Text File Report, 132

Drug Text Management, 130 DSPLY ON IVP/IVPB TAB IN BCMA?, 90

E Edit Cost Data, 167

EDit Drug Cost (IV), 167 Edit Orderable Items, 102 Enable/Disable Dosing Order Checks, 177

Enable/Disable Vendor Database Link, 172 Enter/Edit Dosages, 9

F Formulary Information Report, 129

G

Glossary, 208

I Inpatient Drug Management, 164

Introduction, 1 IV Additive Report, 148 IV Solution Report, 150

L Local Possible Dosages, 180 Local Possible Dosages Report, 23

Local Possible Dosages, Spanish Translations, 237 Lookup into Dispense Drug File, 76

M

Mark PreMix Solutions, 152 MARk/Unmark Dispense Drugs For Unit Dose, 167

Marking a CMOP Drug (Single drug), 6 Medication Instruction File Add/Edit, 80 Medication Instruction File Report, 86

Medication Instruction Management, 80 Medication Instructions, Spanish Translations, 243 Medication Route File Enter/Edit, 90

Medication Route Mapping History Report, 94 Medication Route Mapping Report, 92 Medication Routes Management, 90 Medication Routes, Spanish Translations, 257

Menu Options, 1 Most Common Dosages Report, 19

N

New Term Rapid Turnaround (NTRT), 96 Non-VA Meds, Drug Enter/Edit, 46

Noun/Dosage Form Report, 20


User Manual

O

Order Check Management, 71 Orderable Item Management, 101 Orderable Item Report, 123 Original Drug Text File Entries Combinations, 221

Other Language Translation Setup option, 173

P

PEPS Services, 159 Pharmacy System Parameters Edit, 134 Possible Dosages, 180, 202

PRimary Solution File (IV), 167 Print Interface Data File, 163 PROMPT FOR INJ. SITE IN BCMA, 90

PSXCMOPMGR key, 1, 6

R Report of Locally Entered Interactions, 75

Request Change to Standard Medication Route, 96 Request Changes to Dose Unit, 24 Request Changes to Enhanced Order Check Database, 71

Review Dosages Report, 21 Revision History, i

S

Schedule/Reschedule Check PEPS Interface, 161 Screen prompts, 1 Sig formula, 202 Sig Formulas (Formulas), 201

Simple Local Possible Dosages, 200 Simple Possible Dosage Formula, 202 Simple Possible Dosages, 200

Standard Schedule Management, 135, 148 Supra-therapeutic, 16, 55 Synonym Enter/Edit, 146

T Table of Contents, ix

U Unmarking a CMOP Drug (Single drug), 7

W Warning Builder, 153 Warning Mapping, 157, 168

Documents

Pharmacy Data Management User Manual · 01/18 127 PSS*1*212 Updated Pharmacy System Parameters Edit option 05/17 4 80-81 82-85 129-134 136-137 197 PSS*1*201 Updated Pharmacy Data

Pharmacy Data Management User Manual · 01/18 127 PSS1212 Updated Pharmacy System Parameters Edit option 05/17 4 80-81 82-85 129-134 136-137 197 PSS1201 Updated Pharmacy Data